Predictors of mortality in patients with acute renal failure.

ABSTRACT

Mortality associated with acute renal failure (ARF) remains high despite of developments in therapy strategies and definition of different prognostic factors. Therefore, this study focused on to define new prognostic factors and especially regional characteristics of the ARF patients. One hundred fifteen ARF patients, diagnosed from November 1998 to May 2003, were included to this prospective and observational study. Clinical features, laboratory parameters, Acute Physiology and Chronic Health Evaluation (APACHE) III scores and co-morbid conditions of the patients were examined. Clinical and laboratory data, and APACHE III scores were recorded at the first nephrology consult day. Thirty of the patients (26%) died. APACHE III scores, presence and the total number of co-morbid conditions and serum albumin levels at the time of first nephrology consultation were found as independent predictors of mortality. There was a negative correlation between APACHE III scores and serum albumin levels. Not only increased APACHE III score and presence of co-morbid conditions but also low serum albumin level was found as the predictors of mortality. However, only serum albumin level is seen as modifiable prognostic factor among these parameters. Therefore, further studies are necessary to determine the causes of hypoalbuminemia in patients with ARF and the effect of it's effective treatment on patients outcome.