Fırat Bektaş, Ali Erhan Nokay, Faruk Güngör, Seçgin Söyüncü

Akdeniz Üniversitesi Tıp Fakültesi, Acil Tıp Anabilim Dalı, Antalya


Objectives: The goal of study was to investigate demographic and admission features of patients diagnosed with acute renal failure and to determine indications of emergent hemodialysis.
Materials and Methods: This retrospective study was performed in an ED of a tertiary-care university hospital with an annually census of approximately 60.000 adult visits between 01.01.2006 – 31.12.2006. Over the 18 years of age who presented to emergency department with various symptoms and diagnosed as acute renal failure were included into study. Study patients were determined from the computerized database of the hospital, MediAcil® software, by using International Code of Diseases (ICD-10). ARF is established by ICD-10 of N.17. Patients with known chronic renal failure who diagnosed as acute renal failure were excluded from the study. Demographic and admission features, indications of emergent hemodialysis, treatment of emergency department, conditions of airway and cardiovascular stability, stay in the emergency department and hospital, and one year mortality rate were recorded to the study form.
Results: A total of 79 patients diagnosed as acute renal failure in ED with available records were include in the study. The study subjects had a mean age of 63.7±15.9 years and 57% (n=45) of them were male. Twenty sevenof them (34.2%) were undergone emergent hemodialysis, and fifty of them (63.3%) were treated with various medications. Finally, 73 (92.4%) patients were admitted to the hospital. One year mortality rate was 1 7.7% (n=14). The presenting complaints of the patients varies (Cardiovascular, 20 patients (25.3%); infectious, 17 patients (21.5%); gastrointestinal, 14 patients (17.8%); non-spesific, 13 patients (16.4%) and neorological, 10 patients (10.4%)). There was no relation between mortality and emergent hemodialysis, metabolic acidosis, hyperkalemia, hypervolemia, cardiovascular instability, in emergency department medical and airway treatment, age, gender and patient’ hemodynamic status (p>0.05). The cost analyses revealed the average charge for the study patients as 2196.1±2455.5 New Turkish Lira (YTL) (min: 85 YTL, max: 15766 YTL).
Conclusion: Patients with acute renal failure were admitted to the emergency department with various symptoms. These patients were quickly evaluated and began to renal replacement treatment. Because of the most of these patients is admitted to the hospital, patient’ cost is getting higher. Further studies are needed to investigate indications of admission these patients to the hospital and cost effective treatment methods.