Treatment of acute renal failure

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Presentation transcript:

Treatment of acute renal failure Robert A. Star Kidney International Volume 54, Issue 6, Pages 1817-1831 (January 1998) DOI: 10.1046/j.1523-1755.1998.00210.x Copyright © 1998 International Society of Nephrology Terms and Conditions

Figure 1 Factors that influence steady state creatinine and glomerular filtration rate (GFR) in acute renal failure (ARF). Kidney International 1998 54, 1817-1831DOI: (10.1046/j.1523-1755.1998.00210.x) Copyright © 1998 International Society of Nephrology Terms and Conditions

Figure 2 Dynamic relationship between creatinine and GFR in ARF. Modified from Moran and Myers[8] Kidney International 1998 54, 1817-1831DOI: (10.1046/j.1523-1755.1998.00210.x) Copyright © 1998 International Society of Nephrology Terms and Conditions

Figure 3 Mortality of ARF partly depends on co-morbidity. Data taken from[2,18-20,22]. Kidney International 1998 54, 1817-1831DOI: (10.1046/j.1523-1755.1998.00210.x) Copyright © 1998 International Society of Nephrology Terms and Conditions

Figure 4 ARF is an independent risk factor for death. Data taken from study of Levy et al[24]. Kidney International 1998 54, 1817-1831DOI: (10.1046/j.1523-1755.1998.00210.x) Copyright © 1998 International Society of Nephrology Terms and Conditions

Figure 5 Traditional indices of ICU mortality (APACHE III) underestimate the risk of death in patients with ARF, whereas the Liaño Severity of Illness score is accurate. Symbols are: (♦) observed; (▴) Liaño; (▪) APACHE III). Data are taken from[26],[27]. Kidney International 1998 54, 1817-1831DOI: (10.1046/j.1523-1755.1998.00210.x) Copyright © 1998 International Society of Nephrology Terms and Conditions

Figure 6 Components of Liaño ARF Severity of Illness score[26,29,33]. Kidney International 1998 54, 1817-1831DOI: (10.1046/j.1523-1755.1998.00210.x) Copyright © 1998 International Society of Nephrology Terms and Conditions

Figure 7 Risk of ARF requiring hemodialysis in patients after cardiac surgery. Ovals represent important patient characteristics selected by recursive partitioning analysis. Abbreviations are: Creat Cl, creatinine clearance; CABG, coronary artery bypass grafting only (without valve replacement); IABP, intra-aortic balloon pump; PVD, peripheral vascular disease. Mortality rates: low (0.4%); average (0.9 to 1.4%); moderate (2 to 2.8%); high (5 to 6.1%); very high (9.5%). Modified from[18]. Kidney International 1998 54, 1817-1831DOI: (10.1046/j.1523-1755.1998.00210.x) Copyright © 1998 International Society of Nephrology Terms and Conditions

Figure 8 More dialysis enhances survival. Data from[19]. Symbols are (•) more dialysis; (♦) less dialysis. Kidney International 1998 54, 1817-1831DOI: (10.1046/j.1523-1755.1998.00210.x) Copyright © 1998 International Society of Nephrology Terms and Conditions

Figure 9 Who to enroll in clinical trials with acute renal failure. Kidney International 1998 54, 1817-1831DOI: (10.1046/j.1523-1755.1998.00210.x) Copyright © 1998 International Society of Nephrology Terms and Conditions

Kidney International 1998 54, 1817-1831DOI: (10. 1046/j. 1523-1755 Kidney International 1998 54, 1817-1831DOI: (10.1046/j.1523-1755.1998.00210.x) Copyright © 1998 International Society of Nephrology Terms and Conditions

Kidney International 1998 54, 1817-1831DOI: (10. 1046/j. 1523-1755 Kidney International 1998 54, 1817-1831DOI: (10.1046/j.1523-1755.1998.00210.x) Copyright © 1998 International Society of Nephrology Terms and Conditions