Abstract
Failure of several vital organs including lung, kidney, liver, blood clotting system and gastrointestinal tract forms a clinical syndrome, multiple organ failure. The patient with multiple organ failure is commonly suffering from the systemic effects after major surgey. Acute renal failure associated with postoperative multiple organ failure was evaluated in this study.
Fifty-seven of 2438 patients were diagnosed as multiple organ failure after major surgery during nine years. Twelve of 57 patients had postoperative acute renal failure and were analysed. All patients were over 50 years old but one patient. Number of organs involved in multiple organ failure was 2 in 8 cases, 3 in 3, and 4 in 1 respectively. All patients except one could not survive beyond 60 days after surgery. Acute renal failure preceeded the damage of other organs in all cases.
The causes of acute renal failure in multiple organ failure were infection of intraperitoneal abscess subsequent to leakage of anastomosis, cholangitis, pneumonia or empyema in 10 cases, hepato-renal syndrome after hepatic failure caused by obstructive jaundice in 5, ARDS and DIC in one respectively.
In the diagnosis of acute renal failure it would be emphasized to check urine Na-K ratio which was less 2 in acute renal failure compared with over 2 in controls.
The treatment consists of drainage of abscess performed basically for releasing sepsis and hemodialysis, peritoneal dialysis or plasma exchange.
