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Acute critical illness in patients without previous renal disease increases their risk of kidney complications and death. According to Dr. Shih-Ting Huang and Dr. Chia-Hung Kao, Taichung Veterans General Hospital and China Medical University, Taichung, Taiwan, Patients with acute critical illness without apparent underlying renal disease -a group traditionally considered to be at low risk of renal diseases have clinically relevant long-term renal risks.
This study looked at data on 33 613 Taiwanese patients with critical acute illness and no pre-existing kidney disease compared with 63 148 controls for medium-term renal outcome. More than half the patients (53%) were over age 65 and two-thirds (67%) had high blood pressure.
Patients who had experienced acute kidney illness were at increased risk of renal complications, developing chronic kidney disease and end-stage renal disease, with septicemia and septic shock being the strongest risk factors. Of the critically ill patients in the study, 335 developed end-stage renal disease, with a rate of 21 per 10 000 person-years compared with 4.9 per 10 000 person-years in the control group.
Patients who developed chronic kidney disease and end-stage renal disease were at a higher risk of death. Monitoring kidney function at 30-90 days in patients with acute critical illness without preexisting renal disease and at least yearly after initial check can help.