Twelve years experience of acute renal failure in Taiwan

Summary: A retrospective analysis of the records of 287 patients diagnosed with acute renal failure (ARF) who were admitted between 1 January 1983 and 30 November 1994 to the emergency Service Department of the National Taiwan University Hospital, Taiwan was conducted. A total of 176 men (61.3%) and 111 women (38.7%) were surveyed. the classification of ARF by year revealed a progressive increase in case numbers. the majority (57.5%) of the patients were elderly, particularly in the years 1987-88 and 1993-94, the differences (aged compared with the young) being statistically significant. There were 176 patients (61.3%) in the pre-renal group (with evident intravascular volume depletion, haemodynamic instability or sepsis, with a urine excretion of sodium (FE_Na<1%), 43 (15%) in the renal group (urine analysis revealing protenuria, granular casts or/and tubular epithelial casts and without response to treatment of volume repletion), and 27 (9.4%) in the postrenal group (diagnosed when there were supporting image studies). Overall mortality was 63% and the pre-renal ARF patients had the poorest survival rate (25.6%). the classification of mortality rates by diagnostic category and year revealed a persistently high mortality rate. We conclude that: there are increasing patients with ARF each year; aged patients comprise the majority of cases; and the mortality rate remains high because of the high mortality rate of the pre-renal group, which was due to the presence of complicating underlying diseases and concomitant organ failure. the effects of having an ageing population were also apparent.