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The changing epidemiology of acute renal failure

Nature Clinical Practice Nephrology volume 2, pages 364–377 (2006)Cite this article

A Correction to this article was published on 01 August 2010

Abstract

Different definitions of acute renal failure (ARF) abound. The existence of multiple definitions makes it difficult to determine the true epidemiological characteristics of this condition. Despite this difficulty, it has been possible to detect notable variations in the epidemiology of ARF during the past few decades. The absolute incidence of ARF has increased, while associated mortality rate has remained relatively static. Several factors have contributed to this altered epidemiology. Here, we discuss the relative contribution of these factors, which include site of disease onset (developed or developing countries, community or hospital or intensive care unit), patient age, infections (HIV, malaria, leptospirosis and hantavirus), concomitant illnesses (cardiopulmonary failure, hemato-oncological disease), and interventions (hematopoietic progenitor cell and solid organ transplantation).

Key Points

  • The absolute incidence of acute renal failure (ARF) has increased in the past two decades, while the mortality rate has remained relatively static

  • The lack of a standard definition of ARF complicates the process of identifying the factors that underlie changes in epidemiology of this condition

  • Despite the use of different definitions in different studies, various factors that have contributed to altered epidemiology of ARF in the past few decades have been identified

  • These factors include geographical site of disease onset (developed vs developing countries; community vs hospital vs intensive care unit), patient age, infections (HIV, malaria, leptospirosis and hantavirus), concomitant illnesses (cardiopulmonary failure, hemato-oncological disease), and interventions (hematopoietic progenitor cell and solid organ transplantation)

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Figure 1: RIFLE criteria for classification of acute renal failure.
Figure 2: Percentage distribution of causes of acute renal failure in (A) non-ICU and (B) ICU settings.

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Authors and Affiliations

  1. Emeritus Professor of Medicine at Ghent University,

    Norbert Lameire & Wim Van Biesen

  2. Associate Professor of Medicine at Ghent University and Clinical Director of the peritoneal dialysis program and ambulatory service in the Renal Division of University Hospital, Ghent, Belgium

    Norbert Lameire & Wim Van Biesen

  3. Professor of Medicine at Ghent University and Chief of the Renal Division at the University Hospital, Ghent, Belgium

    Raymond Vanholder

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Lameire, N., Van Biesen, W. & Vanholder, R. The changing epidemiology of acute renal failure. Nat Rev Nephrol 2, 364–377 (2006). https://doi.org/10.1038/ncpneph0218

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