ICUで血液浄化療法を施行した急性腎不全症例の検討

概要

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Objective: To assess the clinical aspects of patients with acute renal failure (ARF) requiring renal replacement therapy (RRT) in our ICU. Design: Retrospective epidemiologic study. Subjects: 126 critically-ill patients with ARF requiring RRT admitted to the ICU from January 1999 to December 2001. Results: The in-hospital mortality was 61.1%. The most common causes of ARF were sepsis and ischemia/low blood pressure. The majority of patients had ARF in conjunction with multiple organ failure, especially the non-survivors. Renal function was recovered in 87.8% of the survivors during hospitalization. The mean length of RRT for non-survivors was 20.4 days. Seventy-four percent of the non-survivors died within 30 days. Discussion and Conclusion: With the advances in medical technology and improved medical techniques, patients in ARF who may not have survived before these advances can live long in ICU. However their condition remains critical and prognosis depends on the severity of the diseases which led to ARF and on concomitant organ failures. Although most survivors recovered renal function, there were some patients who received long-term RRT with no significant benefit and poor prognosis. Attension should be paid in each case to evaluate the severity of ARF and primary and/or coexisting diseases and to decide whether to start (or continue) RRT or not.
一般社団法人日本集中治療医学会の論文
2003-07-01