TITLE

Long-term outcome of acute tubular necrosis: A contribution to its natural history

AUTHOR(S)
Liaño, F; Felipe, C; Tenorio, M T; Rivera, M; Abraira, V; Sáez-de-Urturi, J M; Ocaña, J; Fuentes, C; Severiano, S
PUB. DATE
April 2007
SOURCE
Kidney International;Apr2007, Vol. 71 Issue 7, p679
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
As long-term outcome studies of acute renal failure (ARF) are scarce and non-homogeneous, we studied 187 consecutive acute tubular necrosis (ATN) patients without previous nephropathies, discharged alive from our hospital between October 77 and December 92 and followed-up until December 99 (range 7–22 years; median 7.2). Variables were analyzed at the time of the acute episode and during follow-up. In 2000–2001 a clinical evaluation was made in 58 of the 82 patients still alive. Ten patients were lost to follow-up and 95 died. In 59% death was related with the disease present when the ATN developed. Kaplan–Meir survival curve showed 89, 67, 50, and 40% at 1, 5, 10, and 15 years, respectively, after discharge. Survival curves were significantly better (log-rank P<0.001) among the youngest, those surviving a polytrauma, those without comorbidity and surprisingly those treated in intensive care units. The proportional Cox model showed that age (hazard ratio (HR) 1.04 per year of age; P=0.000), presence of comorbid factors (HR 4.29; P=0.006), surgical admission (HR 0.45; P=0.000), and male sex (HR 1.72; P=0.020) were the variables associated with long-term follow-up. In the evaluated patients renal function was normal in 81%. Long-term outcome after ARF depends on absence of co-morbid factors, cause of initial admission and age. Although the late mortality rate is high and related with the original disease, renal function is adequate in most patients.Kidney International (2007) 71, 679–686. doi:10.1038/sj.ki.5002086; published online 31 January 2007
ACCESSION #
24486821

 

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