急性肾功能衰竭611例的临床流行病学研究

目的 了解急性肾功能衰竭(ARF)的病因构成、预后以及影响ARF病死率的危险因素等临床流行病学特征,为急性肾功能衰竭的早期防治提供理论依据.方法 对广西医科大学第一附属医院2002-01-01～2006-12-31在各科住院的ARF患者的临床资料进行回顾性分析,并研究其病因、临床特征及其转归.结果 观察期间共有住院患者193 038例次,其中611例患者发生ARF,占同期住院人数的0.32%;男女比例为1.87∶ 1.00,中位年龄40岁.肾前性118例(19.31%),肾前性ARF的病因首位为心排出量减低(35例,29.66%);肾实质性372例(60.88%),肾小管间质病变是肾实质性ARF首位病因(236例),其中药物性95例(40.25%);肾后性121例(19.80%),其中尿路结石84例(69.42%).有慢性肾脏病基础ARF共201例,占总ARF的32.90%.观察期间ARF病死率14.89%,Logistic回归分析提示少尿、是否合并MODS、获得性ARF是住院病死率相关的危险因素.结论 心排出量减低、药物性肾损害、尿路结石分别是引起肾前性、肾实质性、肾后性ARF的首位病因;慢性肾脏病基础ARF并不少见.少尿、合并MODS、获得性ARF的患者病死率高.     

急性肾功能衰竭流行病学调查

目的:前瞻性研究急性肾功能衰竭(ARF)发病情况,总结ARF病因和发生率,为早期防治提供理论依据. 方法:收集我院1998年7月～2001年12月各科住院ARF患者269例,分析肾前性、肾实质性和肾后梗阻性ARF的各种病因、发生率、治疗和预后转归. 结果:269例ARF患者中,男性156例,女性113例,平均年龄(49.8±19.6)岁,其中＞60岁组占31.6%.肾前性ARF 37例(13.8%),病因为术后缺血、失液、肾病综合征等.肾实质性ARF 221例(82.2%),其中小管间质病变167例,主要病因为药物、感染、休克、横纹肌溶解综合征(RM)等.药物性ARF 52例,有药物因素参与者54例,两者共计占ARF 39.4%;RM-ARF 16例(5.9%).95例行肾活检,其中小球-小血管病变47例,小管-间质病变(包括急性肾小管坏死和急性间质性肾炎)37例.医源性ARF 90例,占33.5%,病因为外科手术后和肾前性因素以及药物因素.肾后梗阻性ARF 11例,占4%,病因为各种妇科肿瘤和泌尿道肿瘤、畸形、结石、前列腺肥大和后腹膜淋巴结肿大.本组死亡率14.5%,其中校正死亡率(直接与ARF相关的死亡率)12.6%. 结论:ARF流行病学已发生改变,发病呈高龄化趋势,老年ARF发病率上升;肾前性ARF常因认识不足而被忽略;虽然小管间质病变仍是肾实质性ARF主要原因,其中药物因素已占首位.ARF早期诊断有助于治疗,改善预后,提高存活率.     

急性肾功能衰竭流行病学调查

目的前瞻性研究急性肾功能衰竭(ARF)发病情况,总结ARF病因和发生率,为早期防治提供理论依据. 方法收集我院1998年7月～2001年12月各科住院ARF患者269例,分析肾前性、肾实质性和肾后梗阻性ARF的各种病因、发生率、治疗和预后转归. 结果269例ARF患者中,男性156例,女性113例,平均年龄(49.8±19.6)岁,其中＞60岁组占31.6%.肾前性ARF 37例(13.8%),病因为术后缺血、失液、肾病综合征等.肾实质性ARF 221例(82.2%),其中小管间质病变167例,主要病因为药物、感染、休克、横纹肌溶解综合征(RM)等.药物性ARF 52例,有药物因素参与者54例,两者共计占ARF 39.4%;RM-ARF 16例(5.9%).95例行肾活检,其中小球-小血管病变47例,小管-间质病变(包括急性肾小管坏死和急性间质性肾炎)37例.医源性ARF 90例,占33.5%,病因为外科手术后和肾前性因素以及药物因素.肾后梗阻性ARF 11例,占4%,病因为各种妇科肿瘤和泌尿道肿瘤、畸形、结石、前列腺肥大和后腹膜淋巴结肿大.本组死亡率14.5%,其中校正死亡率(直接与ARF相关的死亡率)12.6%. 结论ARF流行病学已发生改变,发病呈高龄化趋势,老年ARF发病率上升;肾前性ARF常因认识不足而被忽略;虽然小管间质病变仍是肾实质性ARF主要原因,其中药物因素已占首位.ARF早期诊断有助于治疗,改善预后,提高存活率.     

老年急性肾衰竭病因及血液净化的疗效分析

目的探讨老年急性肾衰竭病因分析及血液净化治疗对其预后的影响。方法回顾性分析我院2005年1月至2011年6月收治的118例老年急性肾衰竭(ARF)患者的临床资料。结果老年患者ARF病因主要是肾前性,占68.6%(81例);其次为肾性17.8%(21例),肾后性占13.6%(16例)。具体分析发病因素,老年组ARF的首要病因为感染,共37例(31.7%);其次是血容量不足及心脑血管疾病31例(26.6%),肾毒性药物23例(19.5%),外伤及手术17例(14.8%),尿路梗阻8例(7.0%),其他5例(4%)。净化治疗组效果显著优于非净化治疗组(P<0.05)。结论对老年重症ARF患者进行血液净化有助于改善患者的预后。     

急性肾功能衰竭的流行病学状况

目的探讨急性肾功能衰竭（ARF）的流行病学状况,为该疾病的诊治及预防提供依据。方法回顾性分析2003~2006年收治的611例ARF患者的临床资料,观察ARF的发生状况、病因构成及预后特点。结果611例ARF患者中,医院获得性ARF（HA-ARF）78例,社区获得性ARF（CA-ARF）533例。HA-ARF发病率2003~2005年呈上升趋势,引起HA-ARF的病因依次是肾性、肾前性、肾后性因素;与手术相关的HA-ARF占29.49%,以心血管手术更为突出。HA-ARF患者合并多器官功能障碍综合征比例及其病死率较CA-ARF高（分别为52.6%vs19.9%,P〈0.05;39.7%vs 11.3%,P〈0.05）。肾后性因素特别是结石导致CA-ARF的发生率较HA-ARF高（15.8%vs 11.3%,P〈0.05）。结论药物性肾损害是引起肾实质性ARF的首位病因,尿路结石是引起肾后性CA-ARF的首位病因,心血管手术相关HA-ARF的防治亦非常重要。     

老年医院获得性急性肾衰竭的临床分析

目的探讨65岁及以上老年人医院获得性急性肾衰竭(HA-ARF)的特点、病因、预后及其相关因素。方法收集我院11年间诊断的老年HA-ARF病例,统计分析老年HA-ARF的发病情况、病因、预后及其相关影响因素。结果老年HA-ARF占同期老年急性肾衰竭(ARF)患者总数54%,明显高于老年社区获得性ARF(CA-ARF),(P<0.05),并以肾前性ARF(74.4%)为主。多因素综合分析老年HA-ARF病因以感染(33.3%)为首位病因,其次与低血容量(29.6%)、肾毒性药物(27.2%)、心功能衰竭(24.7%)、手术(22.2%)、肿瘤(8.6%)及肾后性疾病(1.2%)相关。老年HA-ARF多由多种病因共同导致。老年HA-ARF的病死率高达66.7%。发生少尿和多器官衰竭(MODS)可明显增加病死率,行血液净化治疗未能明显降低病死率。结论感染、低血容量、肾毒性药物、心功能衰竭及手术是老年人HA-ARF的常见病因。加强原发病的整体治疗,尽早发现并治疗HA-ARF有助于改善预后。     

159例老年急性肾衰竭的临床流行病学

目的探讨老年急性肾衰竭(ARF)的病因构成及预后。方法对该院2002年1月1日至2006年12月31日在各科住院的老年ARF患者进行回顾性分析,并与其他年龄组别进行研究和比较,得出其病因及转归的特点。结果观察期间159例老年患者发生ARF,占同期住院人数的0.35%,占同期ARF的26%;老年ARF患者男女比例为2.46∶1.00。肾前性41例(25.8%),肾前性ARF的病因首位为心排出量减低(16例,39.02%);肾实质性85例(53.5%),肾小管间质病变是肾实质性ARF首位病因(68例,80%),其中药物性35例(41.18%),感染27(31.76%);肾后性33(20.8%),其中尿路结石21例(63.64%),肿瘤7例(21.21%)。与儿童组和中青年组相比,老年组肾前性ARF比例高(25.8%、16.5%、17.2%),由低心排出量(10.1%、3.9%、3.4%)、药物(22.0%、2.9%、16.3%)、感染(17.0%、1.0%、4.9%)病因等引起ARF比例高,合并MODS(32.06%、9.71%、24.64%)的比例高。观察期间老年ARF病死率(23.27%),较儿童组和中青年组...     

81例药物性急性肾衰竭临床分析

目的　总结我院药物所致的急性肾衰竭 (ARF)的发生、临床病理改变、治疗及预后 ,为临床合理用药、最大程度避免药物性ARF的发生提供客观依据。方法　收集我院 410例ARF患者 ,并分析药物所致不同ARF的发生率、预后转归和涉及药物的种类。结果　药物性ARF患者81例 ,占同期收集ARF患者总数 19.8% ,其中男性 5 3例 ,女性 2 8例 ,平均年龄 ( 4 9.74± 19.14 )岁 ,>60岁患者占 3 2 .1%。肾前性ARF 5例 ( 6.1% ) ,肾小管间质病变 72例 ( 88.9% ) ,肾小球血管病变和肾内梗阻各 2例 ( 2 .5 % )。肾活检 2 4例 ,均为肾小管间质病变 ,70 .8%为肾小管坏死。涉及药物中抗生素占首位 ( 3 9.5 % ) ,其中氨基糖甙类抗生素为主要病因 ,其次为造影剂 ( 11.1% )和甘露醇 ( 7.4% ) ,16%患者为 2种或 2种以上药物联合使用。内科组 >60 %患者存在内科基础疾病。2 7.2 %患者需血液净化治疗。药物性ARF治愈率 82 .7% ,与药物直接相关的死亡率 8.6%。结论　ARF病因已发生改变 ,药物因素在本组资料中占首位 ;中老年药物性ARF发生率高于年青者 ;合并内科基础疾病者发生率高 ;抗生素 (主要是氨基糖甙类 )和造影剂是主要的致病因素 ;药物性ARF早期诊断和防治能明显改善预后 ,提高治愈率和存活率     

迎接新的挑战努力提高急性肾损伤的诊治水平

急性肾衰竭（ARF）是临床常见重症急性肾脏疾病。近30年来,ARF的发病率不断上升。有资料显示,随着人群的老龄化、住院患者合并症发生率升高、新的诊疗技术的应用,ARF的发病率每年递增11％。尽管ICU的救治技术和肾脏替代治疗（RRT）取得了显著进步,但ICU患者ARF的病死率仍高达50％～70％;幸存者中有13％的患者在未来的3年内进展为慢性肾衰竭。因此,提高ARF的诊治水平是临床工作中亟待解决的重要问题。[第一段]     

药物引起的急性肾衰竭

肾脏血流丰富，是体内药物代谢和排泌的重要器官，当血液中存在肾毒性物质时，肾脏极易受损。近年来，不仅抗菌药物引起急性肾衰竭（ARF）、慢性肾衰竭日益增多，由血管紧张素转换酶抑制剂（ACEI）类及肿瘤化疗药物所致的肾衰竭也呈上升趋势。药物因素已成为肾实质性ARF的首要病因。药物引起的肾衰竭主要为肾实质性ARF，包括急性肾小管坏死（ATN）、小管间质炎症及肾血管、小球损伤。以下主要针对药物所致的肾实质性ARF展开阐述。     

年龄对老年高血压患者伴急性肾功能衰竭诱发多器官功能衰竭的预测价值

目的分析年龄对老年高血压患者伴急性肾功能衰竭(ARF)后诱发多器官功能衰竭(MODSE)的影响,探讨年龄和ARF对老年高血压患者发生MODSE的预测价值。方法回顾性分析年龄≥60岁的高血压患者19 996例临床资料,以10岁为界分为60～69岁10 644例、70～79岁7427例、80～89岁1750例和≥90岁175例4个年龄段,再以69岁、79岁和89岁为分界点,分别分析4个年龄段及3个年龄分界点上下患者中,因ARF并发MODSE的发生率。结果所有ARF患者MODSE发生率较非ARF患者MODSE发生率明显升高(66.7%vs1.3%,P=0.00)。与60～69岁比较,≥90岁患者发生ARF的比例明显升高(2.8%vs 20.0%,P<0.05);4个年龄段伴ARF发生MODSE分别为51.4%、71.3%、84.9%、94.3%(P=0.00)。年龄与ARF和MODSE均呈正相关(r=1.00,P=0.000);排除年龄因素的影响后,偏相关分析表明,ARF与MODSE无相关性(r=-0.914,P=0.266)。结论年龄是老年高血压患者发生ARF及并发ARF后出现MODSE的重要影响因素。年龄对ARF诱发老年高血压患者发生MODSE具有一定的早期预测价值。     

Obstetrical acute renal failure. Experience of the nephrology department, Central University Hospital ibn Rochd, Casablanca

The gravidic acute renal failure (ARF) becomes a rare complications of the pregnancy in the industrialized countries, whereas it is still frequent in the developing countries and responsible of great maternofetal morbidity and mortality. We studied the etiologic and evolutive aspects of the gravidic ARF in 55 patients during 18 years (1981-1998) at the department of nephrology, hospital center Ibn Rochd in Casablanca. The gravidic ARF represents 65% of the gravidic patients. The mean age of the patients is 30.92 +/- 6.44 years old. The mean parity is 3.38 +/- 2.25. The mean term is 31.73 +/- 10.02 weeks of amenorrhea. The main etiology is the preeclampsia and eclampsia, 41 patients (74.5%); the other causes are: the septic conditions: 6 patients (11%); the obstetrical hemorrhages: 4 patients (7.2%); the in uterofetal death: 3 patients (5.5%) and the post-cesarotomy: 1 patient (1.8%). 74.6% of the patients has been hemodialysed. The evolution has been characterized by the normal recuperation of the renal function is 48 patients (87.3%), a chronic renal failure in 2 patients (3.6%) and the death of 5 patients (mortality: 9.1%). The gravidic ARF is still a critical circumstances associated to a severe prognosis as well as in the woman and the fetus. So, the most effective measures are still the prevention and the managing of the obstetrical complications.     

老年住院患者急性肾衰竭的临床分析

目的探讨65岁及以上老年人急性肾衰竭(ARF)的特点、病因、预后及其相关因素。方法收集我院1995年1月至2005年12月11年间诊断的老年ARF共150例,统计分析老年人ARF的特点、病因、预后及其相关影响因素。结果老年人ARF占同期全部ARF患者总数33%,老年人医院内获得性ARF(HA-ARF)的发生率为54%,明显高于社区获得性ARF(CA-ARF,P<0.05)。老年ARF的发生有逐年增高的趋势。老年ARF以肾前性ARF为主,多因素综合病因分析显示:与感染(56%)相关为首位病因,其次与低血容量(30.7%)、肿瘤(26%)、心功能衰竭(25.3%)、肾毒性药物(22%)、手术(14%)、肾脏疾病(14.7%)及肾后性疾病(8.7%)相关。单因素病因分析显示与低血容量相关为首位病因(21.6%)。老年ARF多由多种病因共同导致,其死亡率高达53.3%,HA-ARF死亡率是CA-ARF死亡率的1.87倍。结论老年人易患ARF。HA-ARF的增多是主要原因。感染、低血容量、肿瘤、心功能衰竭、肾毒性药物及手术是老年人ARF的常见原因。加强原发病的整体治疗,尽早发现并治疗ARF,有助于改善预后。     

老年人急性肾功能衰竭的临床特点

目的：探讨老年急性肾功能衰竭（ARF）的临床特点,方法：将151例ARF病人分为老年组（47例）和对照组（104例）,并比较两组病人的临床资料、治疗方法和预后。结果老年组引起ARF最常邮病因是感染,明显高于对照组（P＜0．01）,而肾实质性疾病引起的ARF明显低于对照组（P＜0．01）。多脏器功能衰竭的发生率、病死率均明显高于对照组（P＜0．01）。治疗开始前血清肌酐水平明显低于对照组（P＜0．01）。接受透析治疗病例数明显低于对照组P＜0．01）。结论老年ARF的原发疾病及临床经过有其特殊性。加强透析治疗,尤其早期预防透析是治疗成功的关键,预后与年龄、原发病能否控制及透析时机的选择有关。     

Acute renal failure in elderly patients

Patients' age and severity of renal insufficiency are important factors in the prognosis of ARF. We analysed, retrospectively, 66 patients over 65 years of age with ARF and requirement of renal function replacement. Mean age was 74.8±7 years. The etiologies of ARF were: obstructive (59%), medical (32%) and surgical (9%). Univariate analysis was undertaken. Hypotension (p=0.005), left ventricular failure (p=0.03), bleeding diathesis (p=0.007) and gastrointestinal haemorrhage (p=0.01) affected prognosis adversely. Mortality was directly related to the number of risk factors (p=0.001) and to the etiology of ARF-obstructive disease had a favorable prognosis (p=0.001). The overall mortality was 34.8% and the main causes of death were cardiovascular (30.4%) and infection (26.1%). Although it is important to define prognostic factors, old age should not be used as a criterion to refuse an opportunity of therapy in ARF.     

老年肾病综合征并发急性肾功能衰竭21例临床分析

目的　深入探讨老年肾病综合征 (NS)并发急性肾功能衰竭 (ARF)的临床、病理及预后。　 方法　对 2 1例老年及 3 8例非老年NS并发ARF患者的病因、临床特征、病理特点以及预后等进行回顾性分析。　 结果　老年组NS并发ARF发病率为 2 4 7% ;非老年组为 7 3 %。老年组与非老年组比较有以下特点 :(1)老年NS并发ARF发病率高 ,男性多见 (71 4% ) ,病死率高 ,治愈率低 ;(2 )蛋白尿程度极重、血浆蛋白极低 ;(3 )病理以膜性肾病、局灶节段性肾小球硬化多见 ;(4 )病因以原发性肾小球疾病、糖尿病肾病为主。　 结论 　老年NS并发ARF发病率高 ,病理以膜性肾病、局灶节段性肾小球硬化为主 ,蛋白尿及低蛋白血症严重 ,预后差。     

Epidemiology of de novo acute renal failure in hospitalized African Americans: comparing community-acquired vs hospital-acquired disease

BACKGROUND: The high incidence and prevalence of end-stage kidney disease among African Americans is well known, but the epidemiology of acute renal failure (ARF) among African Americans is unknown. This study was designed to determine the incidence, associated risk factors, and prognosis of ARF in hospitalized African Americans and to compare these variables in hospital-acquired ARF (HA-ARF) against community-acquired ARF (CA-ARF). METHODS: A 3-year (1994-1996), computer-assisted retrospective analysis of hospital discharges with confirmed diagnoses of ARF. One hundred of 240 cases met the inclusion criteria for de novo ARF. Demographic, laboratory, and clinical profiles of all patients were retrieved and subdivided into CA-ARF and HA-ARF. Both analysis of variance and chi2 tests were used for analysis. Survival regression used both the Cox proportional hazards and Kaplan-Meier models. RESULTS: The incidence of CA-ARF was 3.5 times greater than that of HA-ARF (0.55% vs 0.15%). The mean age of all patients was 54 years with a 67% male predominance. There were no significant differences in age, sex, peak serum creatinine levels, or underlying medical history. Prerenal causes of ARF were more common among CA-ARF than HA-ARF (35% vs 19%; P = .07), but intra-renal causes were more common among HA-ARF (81% vs 55%; P = .07). All cases of obstruction occurred in CA-ARF. Mortality was higher in HA-ARF (59% vs 33%; P = .03), and the incidence of recognized predictors of mortality was higher in patients with HA-ARF than in those with CA-ARF: oliguria (59% vs 35%; P = .04); sepsis (73% vs 35%; P = .004); stay in the intensive care unit (ICU) or mechanical ventilation (55% vs 6%; P<.001); and multiorgan failure (59% vs 24%; P = .002). Those with HA-ARF were twice as likely to require dialysis as those with CA-ARF. The mortality was high in younger patients with CA-ARF and in older patients with HA-ARF, but the dialysis-related mortality rate was 3-fold higher among patients with HA-ARF. While mean +/- SD length of hospital stay was more prolonged in HA-ARF than CA-ARF (26 +/- 28 days vs 12 +/- 11 days; P<.001), the 120-day survival rate was lower in HA-ARF than CA-ARF (43% vs 66%; P = .05). The HA-ARF status was associated with a relative risk of 2.5 (confidence interval, 1.1-5.5; P = .03) for shortened survival. CONCLUSIONS: The overall epidemiologic characteristics of ARF among hospitalized African Americans seem to be comparable to those in whites, but the difference in incidence between CA-ARF and HA-ARF was much higher in African Americans. In view of the high mortality and morbidity rates associated with ARF and the fact that younger African American patients with CA-ARF were more likely to die than their older counterparts, we recommend that renal failure awareness be incorporated into community-based health educational programs in African American populations.     

原发性肾病综合征时的急性肾功能衰竭

目的　探讨原发性肾病综合征 (PNS)并发急性肾功能衰竭 (ARF)的病理特征、治疗方法及预后。方法　回顾分析近 10年间 2 6 1例PNS中并发ARF的 2 2例患者的临床特征、病理结果、治疗方法及预后情况。结果　PNS并发ARF的发生率为 9.9% ,临床治愈好转率为 86 .4% ,需终生透析者 4.5 % ,成活率为 95 .9%。 2 2例中微小病变型肾病 (MCD )占 40 .9% ,膜增殖性肾病(MPGN)占 2 7.3 % ,其共同病理变化是小管间质病变广泛。ARF恢复及NS缓解所需时间 :肾小球病变轻微组为 (2 2 .4± 15 .3)d及 (40 .5± 2 0 .7)d ;肾小球病变较重组为 (2 4.7± 18.6 )d及 (5 7.5±19 .8)d。结论　PNS并发ARF以MCD多见 ,其预后比MPGN好。应兼顾PNS和ARF的两个环节治疗。     

Characteristics of acute renal failure in elderly patients admitted to a small town hospital

We studied the features of acute renal failure (ARF) in elderly patients treated in a hospital, without an intensive care unit, to identify etiological factors and establish adequate preventive measures and treatment. During twelve consecutive months we studied prospectively 99 patients with ARF diagnosed by conventional criteria, an incidence of 1,238 cases per million per year. ARF affected 1.78% of patients admitted to hospital. We analyzed age, sex, serum creatinine, diuresis, etiology, type of ARF, preexisting chronic diseases, treatment, complications and outcome. Preexisting chronic diseases were common, the most frequent being hypertension (54%) and diabetes (39%). Previous treatments for cardiovascular diseases were frequent (angiotensin-renin system blockade 35.4%, diuretics 50.5%). 79% of ARF arose in hospital, 21% outside hospital. ARF was pre-renal in 60%, renal in 31% and post-renal in 9%. 34.7% were caused by volume depletion, 23.4% by low cardiac output and 23.4% by infection. 44.4% of ARF patients had oliguria or anuria latrogenic factors contributed to the ethiology of ARF in 35.3% of patients. Hospital stay was doubled by ARF the presence of ARF and the mortality was 36.4%. The rate was higher in ARF arising in hospital than in ARF acquired before admission. Factors that had a significant influence on the mortality rate were comorbid conditions, oliguroanuria, ARF of renal origin and serum albumin. We conclude that ARF has a high incidence, morbidity and mortality in this elderly population. Volume depletion, associated cardiovascular pathology and pharmacological treatment are important etiological factors in those with ARF outside hospital. Adequate treatment of ARF and avoidance of nephrotoxic medications are necessary in hospital.     

Invasive mechanical ventilation for acute respiratory failure in children with cystic fibrosis: outcome analysis and case-control study

The outcome for cystic fibrosis (CF) patients requiring intubation and invasive mechanical ventilation (IMV) due to acute respiratory failure (ARF) has been poor. Mortality rates have been reported as high as 60-90%. However, a review of mortality in children has not been published in 20 years. Our objectives were to study outcomes in CF patients requiring IMV due to ARF between 1988-1998, compare recent outcomes with those previously reported, and identify risk factors associated with poor outcome. We additionally attempted to identify factors suggesting an increased risk of developing ARF requiring IMV. A retrospective cohort study design was used, comparing IMV survivors and nonsurvivors with a nested case-control study to identify risk factors for ARF leading to IMV. All patients cared for at our Center who required IMV for ARF between 1988-1998 were identified. Outcome, age, steroid use, forced vital capacity (FVC), forced expired volume in 1 sec (FEV(1)), microbiology, nutritional status, CF-related diabetes (CFRD), liver dysfunction, and history of major hemoptysis (HEM) or pneumothorax (PTX) were recorded. Cases were matched for gender and age with CF controls identified through a clinical database.Thirty-eight episodes of IMV due to ARF were reported in 33 patients. Three subjects underwent IMV on two or more occasions, but only the first episode was included in analysis. Older age was the only factor that was significantly associated with mortality: 9 subjects were <5 years of age (mortality, 22%), while 24 were 5-34 years old (mortality, 75%) (P = 0.013). There was an increased risk of having an episode of ARF requiring IMV in malnourished subjects (OR = 4.2; 95% CI = 1.66-10.51) and in those with a history of HEM (OR = 6.3; 95% CI = 1.75-22.65).Infants and young children with CF requiring IMV due to ARF have a favorable prognosis, whereas those >or=5 years of age suffer significantly higher mortality. Malnutrition and a history of HEM are important risk factors for having an episode of ARF requiring IMV.