Twelve years experience of acute renal failure in Taiwan

Abstract

Summary: A retrospective analysis of the records of 287 patients diagnosed with acute renal failure (ARF) who were admitted between 1 January 1983 and 30 November 1994 to the emergency Service Department of the National Taiwan University Hospital, Taiwan was conducted. A total of 176 men (61.3%) and 111 women (38.7%) were surveyed. the classification of ARF by year revealed a progressive increase in case numbers. the majority (57.5%) of the patients were elderly, particularly in the years 1987‐88 and 1993‐94, the differences (aged compared with the young) being statistically significant. There were 176 patients (61.3%) in the pre‐renal group (with evident intravascular volume depletion, haemodynamic instability or sepsis, with a urine excretion of sodium (FENa<1%), 43 (15%) in the renal group (urine analysis revealing protenuria, granular casts or/and tubular epithelial casts and without response to treatment of volume repletion), and 27 (9.4%) in the postrenal group (diagnosed when there were supporting image studies). Overall mortality was 63% and the pre‐renal ARF patients had the poorest survival rate (25.6%). the classification of mortality rates by diagnostic category and year revealed a persistently high mortality rate. We conclude that: there are increasing patients with ARF each year; aged patients comprise the majority of cases; and the mortality rate remains high because of the high mortality rate of the pre‐renal group, which was due to the presence of complicating underlying diseases and concomitant organ failure. the effects of having an ageing population were also apparent.