Acute renal failure in the ICU setting: A prospective observational study.

BACKGROUND: Acute renal failure (ARF) is a common entity in the intensive care unit (ICU) setting. There is scanty data regarding acute kidney injury (AKI) in ICUs from our country and no data from the service setting. METHODS: All patients admitted to the ICU of a tertiary care teaching hospital for six months were included in the study. They were divided into two groups: surg gr (admitted in surgical ICU) and med gr (admitted in medical ICU). During the stay in ICU, patients were observed for the development of AKI depending on the creatinine values and hourly urine output. Staging was done based upon the Risk Injury Failure Loss and End stage kidney (RIFLE) criteria. Relevant data associated with development of AKI was collected for correlation. RESULTS: 17.15% patients developed AKI after admission to the ICU 40% patients admitted with sepsis developed AKI. An increased susceptibility to develop AKI was found on day 4 of admission in both the groups. Of the patients who developed AKI, the surg gr of patients had a higher sequential organ failure assessment (SOFA) score both on day of admission (7.85 vs 5.65) and on the day of development of AKI (9.47 vs 6.18) as compared to the medical group. CONCLUSION: The incidence of ARF in our study was 17.2% with the patients of polytrauma/MODS being of major concern. The initial 3-4 days are the most critical and susceptible patients must be intensive monitored during this time for prevention of ARF. Medical ICU patients develop ARF at a low SOFA score in comparison to surgical ICU patients and thus need greater attention.