The mortality of critically ill patients who develop acute renal failure (ARF) is persistingly high. We reviewed all patients who developed ARF that required dialysis in a single intensive care unit (n = 167) during the period 1977 to 1989, in order to identify variables with possible influence on outcome. Overall mortality within hospital was 75%. Age above 60 (p < 0.02), requirement for mechanical ventilation (p < 0.0005), requirement for inotropic drugs (p < 0.0005) and increased levels of P-bilirubin (p < 0.005) had negative impacts on survival. Mortality increased significantly from 63% in the early period (1977-1985) to 84% in the late period (1986-1989) (p < 0.001), a rise that could not be explained by a single variable. The patients in the later period were, though, characterized by a higher morbidity with a higher frequency of additional organ failure.

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