Patients with ischaemic, mixed and nephrotoxic acute tubular necrosis in the intensive care unit – a homogeneous population?

2006

Characteristics and Outcomes of Patients with Acute Tubular Necrosis in ICU

Sample size: 524 publication 10 minutes Evidence: moderate

Author Information

Author(s): Santos Wilson JQ, Zanetta Dirce MT, Pires Antonio C, Lobo Suzana MA, Lima Emerson Q, Burdmann Emmanuel A

Primary Institution: Hospital de Base, São José do Rio Preto Medical School, São Paulo, Brazil

Hypothesis

Are there significant differences in demographic data, clinical picture, and mortality between ischaemic, nephrotoxic, and mixed acute tubular necrosis?

Conclusion

Ischaemic and mixed acute tubular necrosis are associated with higher mortality rates and different clinical characteristics compared to nephrotoxic acute tubular necrosis.

Supporting Evidence

Ischaemic ATN accounted for 51% of cases, mixed ATN for 38%, and nephrotoxic ATN for 11%.
Mortality was 66% for ischaemic ATN, 63% for mixed ATN, and 38% for nephrotoxic ATN.
Multiple organ failure was more frequent in ischaemic (46%) and mixed (55%) ATN than in nephrotoxic ATN (7%).
Oliguria was the only variable universally associated with death across all groups.

Takeaway

This study looked at patients with kidney problems in the ICU and found that those with certain types of kidney damage had a much higher chance of dying than others.