Renal failure in the intensive care unit acute kidney injury compared to end-stage renal failure 英文参考文献.docVIP

Available online /content/12/5/432 Letter Renal failure in the intensive care unit: acute kidney injury compared to end-stage renal failure Marlies Ostermann1 and René Chang2, for the Riyadh ICU Program Users Group 1Guy’s St Thomas’ Hospital, Departments of Critical Care and Nephrology, London SE1 9RT, UK 2St Georges Hospital, Department of Nephrology Transplantation, London SW17 0QT, UK Corresponding author: Marlies Ostermann, Marlies.Ostermann@gstt.nhs.uk Published: 31 October 2008 Critical Care 2008, 12:432 (doi:10.1186/cc7085) This article is online at /content/12/5/432 ? 2008 BioMed Central Ltd Patients with advanced acute kidney injury (AKI) and end- stage dialysis dependent renal failure (ESRF) are charac- terized by loss of renal function as well as significant associated co-morbidities. However, prognosis appears to differ when they are admitted to the intensive care unit (ICU). Patients with advanced AKI have a reported ICU mortality between 25% and 90%, depending on the specific patient population and the definition of AKI [1,2], whereas ICU mortality in ESRF patients has been reported to be 9% to 26% [3-5]. In contrast, Uchino and coworkers [5] found no difference in outcome between 32 ESRF patients in an ICU and 32 diagnosis and severity score matched patients with AKI treated with renal replacement therapy (RRT). We retrospectively analyzed the Riyadh Intensive Care Program database of 41,972 adult patients admitted to ICUs in 19 hospitals in the UK and three hospitals in Germany between 1989 to 1999, and we compared ESRF patients and patients with advanced AKI (defined by serum creatinine ≥354μmol/l, treatment with RRT or a rise in serum creatinine by 300% from baseline). A total of 797 patients had pre- existing ESRF and 2,782 patients had advanced AKI, of Table 1 Characteristics of pat