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Insuficiencia renal aguda en el paciente críticamente enfermo

Keywords: acute renal insufficiency, intensive care, mechanical artificial ventilation, epidemiology.

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Abstract:

factors predisposing and complicating appearance of acute renal insufficiency and its influence on discharge status remain unknown in patients presenting with this entity in a permanent way. to know its incidence and risk factors, we performed a descriptive and analytical study of cases and controls in patients admitted in intensive care unit (icu) of “dr. luis díaz soto” higher institute of military medicine, who developed acute renal insufficiency over a period from january 1, 2003 to december 31 2004. among them we compared age, sex, admission cause, discharge status, apache ii predictive system at 24 hours of admission in polyvalent icu, need of inotropic drugs, ph, pao2 /fio2 relationship, and use of nephrotoxic drugs. authors identified a total of 29 patients presenting with acute renal insufficiency (mean age 58,0 ± 14,0 years), and 58 without this entity (mean age 59,0 ± 13,6 years). incidence of acute renal insufficiency was of 7.8 %. sixty eight percentage (68 %) of patients having acute renal insufficiency, dead. we conclude that in spite of the low incidence of this condition, its mortality index remains high. multivariate analysis showed ; that superadded sepsis ( or: 2.20 %, ci of 95 %, 1.5-5.3; p= 0.001), and high scoring (> 24) in apache ii predictive system at 24 hours of admission ( or: 1,91; ci of 95 %, 1.1-3.2; p= 0,001), are independent risk factors for development of the acute renal insufficiency in this study.

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