The Clinical Outcome and Related Factors of ARF in Survived Patients after CPR / 대한신장학회잡지

ABSTRACT

BACKGROUND: The purpose of the study was to evaluate the prevalence, related factors, and outcome of acute renal failure (ARF) developed in the patients who survived following a cardiac arrest. METHODS: A retrospective analysis of medical records was underwent in 24 patients who survived among 68 patients receiving cardiopulmonary resuscitation (CPR) at the emergency center of Inha-hospital, Sungnam, Korea, from January 1999 to February 2001. Clinical factors before, during and after CPR were compared and contrasted between the patients who manifested ARF after CPR and those who did not. RESULTS: ARF occurs at 33% following CPR. ARF group showed high baseline creatine kinase (CK) level, longer duration of resuscitation, and larger dosages of epinephrine usage during CPR. During 24 hours after CPR, mean arterial pressure and hourly urine output were significantly lower and dopamine was administered significantly higher in ARF group. Among them seven patients died in 2.3+/-0.8 hospital day with a mean serum creatinine of 2.8+/-1.7 mg/dL. None required renal replacement therapy in ARF group. Mean admission durations were 4.4+/-2.8 and 14.0+/-11.5 days. Survival rate was 12.5% in ARF group, which was significantly low compared to 75% in non-ARF group. CONCLUSION: In spite of high mortality rate in ARF group, ARF by itself was not a direct cause of death. We suggest that the development of ARF is a predicting but not a causative factor of death in the survivors following CPR.