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J Korean Soc Emerg Med > Volume 15(4); 2004 > Article
Journal of The Korean Society of Emergency Medicine 2004;15(4): 240-247.
Evaluation of Prognostic Factors in Acute Renal Failure at the Emergency Department
Kyung In Youm, Seung cheol Han, Young Yun Yun, Joeng Mi Mun, Byeong Jo Chun, Tag Heo, Yong Il Min
Department of Emergency Medicine, Chonnam National University, School of Medicine, Gwangju, Korea. minyi@chonnam.ac.kr
This study intended to identify prognostic factors influencing recovery, progressing chronic renal failure (CRF) and mortality in acute renal failure (ARF) patients at the emergency department.
We retrospectively analyzed 104 patients with ARF and with serum creatinine (Cr) level above 2 mg/dL and glomerular filtration rate (GFR) < 62.5 mL/min/ 1.73m2 (< 50%), who were treated at the emergency department fome Jan. 1998 to Aug. 2003. RESULT: Among the 104 patients, 71 patients were male and 33 patients were female. The overall mortality was 16.3%. Based on a univariate analysis, sex, age > 60 years, underlying disease, cause of ARF, urine volume, existence of oliguria, duration of oliguria, proteinuria, GFR, serum BUN, serum Cr, BUN/Cr ratio, arterial pH, PaO2, S a O2, serum Na+, serum K+, serum albumin, serum total bilirubin, serum osmolarity, serum AST, serum ALT, serum creatine kinase, and serum myoglobin were all significant factors discriminating between recovery patients and nonrecovery patients (progressing CRF, mortality). Based on a multivariate analysis, sex, existence of oliguria, duration of oliguria, GFR, BUN/Cr ratio, PaO2, serum K+, SaO2, serum bilirubin, and serum osmolarity were useful factors which might affected non-recovery.
In ARF, the prognostic factors were serum K+, S a O2, duration of oliguria, and BUN/Cr ratio. The higher serum K+, the lower SaO2, the longer the duration of oliguria, and the lower the BUN/Cr ratio are for ARF patients at the emergency department, the more the intensive care emergency physician must perform.
Key words: Acute renal failure, Progression, Emergency
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