Aim and objectives: To develop a renal failure severity scoring system for deciding on need for urgent dialysis.Toassess the efficacy of system in terms of mortality andmorbidity.

Material and methods: –Thisstudy was conducted in387 patients admitted in medicine wardsN. S. C. B. MCH Jabalpur with diagnosis of altered renal function due to various causes (acute and chronic), over a period of one year (October 2013 to September 2014). A self structured renal failure severity scoring system develop in which included Variables like Age, Sex, Etiology , Acute kidney injury , Chronic kidney disease , Physical signs (Pulmonary edema, Acidotic breathing , Urine output , Signs of uremic encephalopathy), Biochemical parameters (Blood urea ,Serum creatinine ,Serum potassium, Serum bicarbonate) and by this scoring system asses the patients who need for urgent dialysis. The data of the present study was recorded into computer and after proper validation, error checking, the data was compiled and analysed using the SPSS Windowand it is compared with previous years in same institute when this scoring system was not followed.

Result and conclusion: –It was observed that, during the period of study out of 387 Cases of renal failure, 230 ultimately required dialysis (59.4%). 99 patients expired that included both dialysis and nonedialysis. Net mortality was 25.58%.