Insuficiencia renal aguda en pacientes con y sin sepsis: pronóstico y evolución / Acute renal failure in septic and non septic patients: prognostic and evolution

ABSTRACT

The purpose of this prospective study was to determine whether the course and prognosis of acute renal failure (ARF) in patients with and without sepsis are different. 252 (8 percent) of 3086 consecutive patients admited to a medical surgical intensive care unit (ICU) developed ARE. One hundred forty-nine (59 percent) were septic and 103 (41 percent) were non-septic. No differences were founded between groups regarding the incidence of oliguria, hyperkalemia, hypercatabolism, gastrointestinal bleeding, duration of oliguria and renal deficit, severity of azotemia, dialysis requirements and duration of stay in the hospital. There were statistically significant differences between septic and non septic patients with respect to hyponatremia (67.8 vs 54.4 percent, p<0.04), respiratory failure (68 vs 54 percent, p<0.04), and thrombocytopenia (64 vs 48 percent, p<0.02). Mortality in septic patients was higher than in non-septics (56 vs 42.7 percent, p<0.009). Factors associated with increased mortality in ARF septic patients were respiratory failure, metabolic acidosis and oliguria while in the non-septics they were hepatic dysfunction, hyperkalemia, respiratory failure and infection acquired during the course of renal failure. We conclude that ARF developing in septic patients has a higher mortality than that of non-septic patients, whereas the incidence of hypercatabolism and oliguria was not different between both groups