Projects / Programmes
Prognostic indexes in the evaluation of quality of dialytic treatment and survival rate of the patients with acute renal failure as a part of multi organ failure
| Code |
Science |
Field |
Subfield |
| 3.06.00 |
Medical sciences |
Cardiovascular system |
|
| Code |
Science |
Field |
| B560 |
Biomedical sciences |
Urology, nephrology |
prognostic indexes, acute renal failure, survival rate, treatment, hemodialysis
Researchers (10)
Organisations (1)
Abstract
Recent advances in tecnology and technique of the treatment of critically ill patients with acute renal failure (ARF) as part of multi organ failure (MOF) did not substantially changed high mortality rate of the patients which ranges from 40% to more than 80%. The most important reasons for that situation has been advanced age and comorbidity of the patients before the admission to the hospital and high quality of hospital treatment which has enabled critically ill patients to survive long enough to develop and clinically reveal ARF.
In 1985, acute physiology and chronic health evaluation classification system (APACHE II) was introduced as a severity of the disease classification system, which was used especially in intensive care units (ICUs) to evaluate severity of the disease of patients and to predict their outcome. Later, evaluation of number of failing organs and organ systems has become also useful and accurate prognostic index.
Critically ill patients with ARF as part of MOF which were trated in Univ. Med. Center in Ljubljana have been treated either with intermitent hemodialysis and every day extended hemodialysis or continuous hemofiltration therapies in order to maintain normal or at least acceptable fluid balance, normal concentration of electrolytes and acceptable concentration of serum urea and creatinine. According to recent studies mortality rate of those patients in our hospital reached 57% in children and 81% in adults.
In the prospective clinical investigation, patients, who will need dialytic therapy because of ARF, will be evaluated using APACHE II scoring system and prognostic index, based on organ failure, patient*s age and comorbidity. The greater the score, the lower the possibility to survive. Survival rate could be increase if patients with greater chance to survive would have been treated with the most efficient dialytic therapy. All patients, without exceptions, will be given optimal dialytic therapy, as was our policy in the past.
