Prognostic factors of postoperative acute renal failure

Fifty-one patients (39 males, 12 females) who developed postoperative acute renal failure (ARF) were retrospectively analyzed to identify factors that could be used to predict survival and renal function recovery. The mortality rate was 45.1% (23/51). The renal function recovery rate was 45.1% (23/51). The majority of operations performed were cardiovascular surgery (68.6%), general surgery (19.6%), hepatobiliary surgery (7.8%), and neurosurgery (3.9%). The etiologies of postoperative ARF were cardiogenic shock (41.2%), sepsis (25.5%), hypovolemic shock (23.5%), drug nephrotoxicity (15.5%), hepatorenal syndrome (2.0%), aortic dissecting aneurysm with renal artery involvement (2.0%), and others (5.9%). The causes leading to mortality were septic shock (65.2%), hypovolemic shock (21.7%), cardiogenic shock (13.1%), and hepatic failure (4.4%). Statistically significant differences were found among 8 clinical variables between the survivors and non- survivors. They were: postoperative APACHE II scores, number of postoperative organ dysfunctions, peak postoperative blood urea nitrogen and creatinine levels, septic shock, oliguria, necessity of dialytic support, and recovery of renal function. The significant variables predicting renal function recovery of postoperative ARF were postoperative APACHE II scores, number of postoperative organ dysfunctions, peak postoperative creatinine levels, postoperative sepsis, oliguria, and dialytic support.