Impact of a high-dependency care area on the nutritional management of patients with acute uremia.

At this institution, all non-intensive care unit (ICU)-based patients with acute uremia were previously managed on the general nephrology ward, and there were concerns that these patients may not have been benefiting from optimal management, particularly with regard to nutrition. In 1998, a renal high-dependency care (RHDC) unit was established within the ward, providing opportunity to compare the clinical management and outcomes of acutely uremic patients in 2 annual cohorts that were admitted both before and after implementation of the RHDC unit. Retrospective case reviews complemented data collected prospectively on the unit since 1995. There were 108 patients included from 1995 to 1996 and 86 patients included from 1998 to 1999; no patients were excluded, but a few case records were unobtainable. Both patient groups were demographically similar (median age, 68 years pre-RHDC, 62.5 years with the RHDC unit), and initial illness severity/comorbidity showed no significant differences. Nutritional support increased significantly (P