Implementation of RIFLE criteria and assessment of factors that affect the prognosis in patients with acute renal failure in intensive care

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Objective: Acute renal failure (ARF) was seen in 5-20% of patients in intensive care unit (ICU). The disturbances of metabolic and hormonal functions contribute to increase the rate of mortality and morbidity in the patients whose have ARF. In our study, firstly we separated the patients, have ARF, into the groups as RIFLE classification after that we compared the collected data from clinic and laboratory, at the same time we evaluated the factors may effects the prognosis of patients. Methods: The fifty patients that have ARF in the intensive care unit of Başkent Universty Hospital were included. The patients divided into three groups, which are called risk, injury and failure according to RIFLE classification. The grouped patients are compared as laboratory and clinical features. We planned that divide the patients into two groups as died and alive according to prospective follow up, when we put diagnosis, we record the vital signs and laboratory values. Results: There is a considerable difference as statistical between RIFLE groups about insulin resistance (HOMA-IR). (p =0,034, p =0,004). When we compare the patient whether they needs hemodialysis or not, during the patient being at intensive care unit, and mortality rate, we saw considerable difference as statistical (p =0,017, p =0,010, p =0,001). Glucose, insulin level, and HOMA-IR observed meaningful as statistical in the exitus groups. (p =0,040, p=0.048, p =0,001). Conclusion: We think that the close monitoring of blood glucose and the controlled insulin treatment may be beneficial by taking into consideration of high mortality rate in the patient with ARF accompanying hyperglycemia and insulin resistance.

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ARF , RIFLE classification , hyperglycemia , prognosis

Dicle Medical Journal

561

Dicle Medical Journal