Acute renal failure: factors influencing nephrology referral and outcome

I H Khan, G R Catto, N Edward, A M Macleod

Research output: Contribution to journalArticle

61 Citations (Scopus)

Abstract

We investigated the incidence, factors affecting referral and outcome of acute renal failure (ARF), in an unselected (predominantly Caucasian) population in the Grampian region of Scotland served by a single renal unit. Case-notes were examined for all patients with a serum creatinine > or = 300 mumol/l. ARF (311 patients) was defined as a temporary rise in serum creatinine > or = 300 mumol/l, or, if the patient died during the acute illness, clinical features indicating acute deterioration of previously normal renal function. Advanced ARF at presentation (51 of the 311 with ARF) was defined as a first recorded serum creatinine > or = 500 mumol/l. Patients were classified into low-, medium-, and high-risk groups according to presence of comorbidity and age. The annual incidence of ARF was 620/million population (pmp), that of advanced ARF 102 pmp. The age-related incidence of ARF ranged from 30 pmp in the age group (0-19 years) to 4266 pmp in the age group > 80 years. Overall, 22% were referred to a nephrologist (34% after excluding those with advanced cancer and age > 80 years). Referral of patients decreased from 100% in the age group 0-19 to 5% in those > 80 years. Referrals in the low-, medium- and high-risk groups were 75%, 30% and 14%, respectively. Patient survival at 2 years was 80%, 42% and 19% for low-, medium-, and high-risk groups, respectively (86%, 44% and 32% for referred patients). Referral and outcome in patients with ARF were significantly influenced by age and presence of comorbidity at presentation.
Original languageEnglish
Pages (from-to)781-5
Number of pages5
JournalQJM
Volume90
Issue number12
Publication statusPublished - 1 Dec 1997

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Nephrology
Acute Kidney Injury
Referral and Consultation
Creatinine
Age Groups
Comorbidity
Incidence
Serum
Kidney
Scotland
Population
Survival

Keywords

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Child
  • Child, Preschool
  • Comorbidity
  • Creatinine
  • Female
  • Humans
  • Infant
  • Kidney Failure, Acute
  • Male
  • Middle Aged
  • Referral and Consultation
  • Renal Dialysis
  • Risk Factors
  • Treatment Outcome

Cite this

Khan, I. H., Catto, G. R., Edward, N., & Macleod, A. M. (1997). Acute renal failure: factors influencing nephrology referral and outcome. QJM, 90(12), 781-5.

Acute renal failure: factors influencing nephrology referral and outcome. / Khan, I H; Catto, G R; Edward, N; Macleod, A M.

In: QJM, Vol. 90, No. 12, 01.12.1997, p. 781-5.

Research output: Contribution to journalArticle

Khan, IH, Catto, GR, Edward, N & Macleod, AM 1997, 'Acute renal failure: factors influencing nephrology referral and outcome', QJM, vol. 90, no. 12, pp. 781-5.
Khan IH, Catto GR, Edward N, Macleod AM. Acute renal failure: factors influencing nephrology referral and outcome. QJM. 1997 Dec 1;90(12):781-5.
Khan, I H ; Catto, G R ; Edward, N ; Macleod, A M. / Acute renal failure: factors influencing nephrology referral and outcome. In: QJM. 1997 ; Vol. 90, No. 12. pp. 781-5.
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AB - We investigated the incidence, factors affecting referral and outcome of acute renal failure (ARF), in an unselected (predominantly Caucasian) population in the Grampian region of Scotland served by a single renal unit. Case-notes were examined for all patients with a serum creatinine > or = 300 mumol/l. ARF (311 patients) was defined as a temporary rise in serum creatinine > or = 300 mumol/l, or, if the patient died during the acute illness, clinical features indicating acute deterioration of previously normal renal function. Advanced ARF at presentation (51 of the 311 with ARF) was defined as a first recorded serum creatinine > or = 500 mumol/l. Patients were classified into low-, medium-, and high-risk groups according to presence of comorbidity and age. The annual incidence of ARF was 620/million population (pmp), that of advanced ARF 102 pmp. The age-related incidence of ARF ranged from 30 pmp in the age group (0-19 years) to 4266 pmp in the age group > 80 years. Overall, 22% were referred to a nephrologist (34% after excluding those with advanced cancer and age > 80 years). Referral of patients decreased from 100% in the age group 0-19 to 5% in those > 80 years. Referrals in the low-, medium- and high-risk groups were 75%, 30% and 14%, respectively. Patient survival at 2 years was 80%, 42% and 19% for low-, medium-, and high-risk groups, respectively (86%, 44% and 32% for referred patients). Referral and outcome in patients with ARF were significantly influenced by age and presence of comorbidity at presentation.

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