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—To determine if the high mortality in acute renal failure is explained by underlying illnesses (comorbidity).

—Cohort analytic study.

—An 826-bed general hospital providing primary, secondary, and tertiary care.

—From 16248 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.

—Death during hospitalization.

—The mortality rate in subjects without renal failure was 7%, compared with 34% in the corresponding index subjects with renal failure (odds …