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| 비 핍뇨성 급성 신부전의 임상상 |
| 윤영석 , 윤건호 , 김석영 , 구완서 , 최의진 , 장윤식 , 방병기 |
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| Abstract |
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A retrospective analysis of case records of all patients who developed actue renal failure (ARF) in Catholic Medical Center during the last six year period 1983 -1988 was made. There were 250 patients (158 males and 92 females) in age range of 10 to 76 years. Of the total 250, 221 (88.4%) developed ARF due to medical causes, which included hemorrhagic fever with renal syndrome (45.2%), drug and chemicals (14.4%), sepsis (8.8 %), rhabdomyolysis (4.8 %), acute glomerulonephritis (3.6%), and miscellaneous causes (7.2%) Nineteen (7.6%) patients were due to surgical causes, which included ARF developing after various surgical procedures, burns and curshing injuries. The prevalences of non-oliguric and oliguric ARF were 52.8 % (n=132) and 47.2% (n=118), respectively. On admission, the patients with oliguric ARF had a more severe characteristics including oliguria (p<.001), leukocytosis (p<.01), concentrated urine (p<.001), higher urinary Na concentration (p<001), higher FENa (p<.01), metabolic acidosis (p<.01) than those of non -oliguric one. Overall mortality rate was 20.4. Mortality rate in patient with oliguric ARF (32.2%) was significantly higher than that of non-oliguric one (9.8%) (p<.0001). Mortality rates in patient with ARF due to surgical (56. 3%) and obstetrical causes (50.0%) were significantly higher than that of medical causes (18.4%) (p<.0001, repectively). The most common causes of death were sepsis (25.5 %), underlying disease (20.2%), shock (17.0%), hyper- kalemia (14.9%), pulmonary edema (8.5%), ARDS (4.3%) and miscellaneous (9.6%). |
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