The effect of acute renal failure on mortality: A cohort analysis

Abstract

Objective. - To determine if the high mortality in acute renal failure is explained by underlying illnesses (comorbidity). Design. - Cohort analytic study. Setting. - An 826-bed general hospital providing primary, secondary, and tertiary care. Patients. - From 16 248 inpatients undergoing radiocontrast procedures between 1987 and 1989, we identified 183 index subjects who developed contrast media-associated renal failure (defined as an increase in serum creatinine level of at least 25%, to at least 177 μmol/L [2 mg/dL], within 2 days of receiving contrast material) and 174 paired subjects, matched for age and baseline serum creatinine level, who underwent similar contrast procedures without developing renal failure. Main Outcome Measure. - Death during hospitalization. Results. - The mortality rate in subjects without renal failure was 7%, compared with 34% in the corresponding index subjects with renal failure (odds ratio, 6.5; P