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Survival and Quality of Life Support Aggressive Treatment of Acute Renal Failure
A DGReview of :"Long-term outcomes in acute renal failure patients treated with continuous renal replacement therapies"
American Journal of Kidney Diseases
08/09/2002
By Mark Pownall
Patients with acute renal failure have good survival and quality of life after discharge and should be treated aggressively in the intensive care unit, researchers report.
There is a lack of data on the prognosis of acute real failure patients after hospital discharge, researchers write. Their study shows that half of those who survive their stay in hospital live for more than five years, with over three quarters rating their current health status as good to excellent.
Admission to hospital with acute renal failure is associated with a very high in-hospital mortality rate -- 69 per cent of the 977 patients with acute renal failure who needed continuous renal replacement therapies died in hospital, write the researchers, from the department of nephrology and medical biometrics, Humboldt University, Campus Charité Mitte, in Berlin, Germany.
Post-discharge survival rates were surprisingly good, the researchers write. Kaplan-Meier analyses showed that the 267 patients who were followed after discharge had a 77 percent probability of surviving the first six months. Survival probability at one year was 69 percent and at five years it was 50 percent.
More likely to survive were patients who were younger and who had one or no comorbidities.
The researchers found that 57 percent of the patients looked after themselves independently and 49 percent said their quality of life had improved after discharge. However 41 percent still had renal insufficiency and 10 percent needed to have chronic haemodialysis.
The researchers conclude that acute renal failure is linked to a high death rate in hospital, but that those who are discharged have a reasonable survival rate, and a good quality of life. ?We conclude that aggressive intensive care unit treatment is justified in these patients,? they write.
Am J Kidney Dis 2002; 40: 275-279.
"Long-term outcomes in acute renal failure patients treated with continuous renal replacement therapies"
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