Kidney Failure Causes Many ICU Deaths

One of every 20 patients in the intensive care unit (ICU) develops a severe form of acute renal failure (ARF) and an alarming number of them die in the hospital, according to a large international study published in the August 17, 2005, issue of the Journal of the American Medical Association.

The study was conducted by an international group of critical care and nephrology experts to gather baseline information on ARF. Prior to this study, there was very little epidemiologic information on ARF on a global level, which made it difficult for researchers to design clinical trials on potential interventions.

The data were gathered from 29,269 critical care patients from 54 medical centers in 23 countries over the span of 15 months. The researchers found that universally almost 6% of these patients developed ARF while in the hospital and 60% of these patients died while hospitalized. Another finding was that 86% of the surviving patients were not dependent on dialysis after discharge, which could be an important clue in treating ARF, according to the researchers.

"Before we try to develop treatments for ICU patients with acute renal failure, we first need to understand how big the problem is and in whom it arises,” said corresponding author John Kellum, M.D., professor of critical care medicine at the University of Pittsburgh School of Medicine (PA, USA). "We have provided a good foundation for understanding with this study.”

The study was called Beginning and Ending Supportive Therapy for the Kidney (BEST Kidney). The researchers contributing to the study were from Australia, Germany, Belgium, Hong Kong, The Netherlands, Brazil, Italy, Canada, and the United States.

"It's interesting that a person in any hospital, in any country has such a high risk of having kidney failure,” added Dr. Kellum. "An estimated five million Americans will go to the ICU this year, and if this number holds true, about 250,000 will go into acute renal failure. Compare this with the 100,000 Americans who will develop chronic renal failure this year and the numbers are staggering.”