Abstract
During the fifteen-year period from February, 1974, to December, 1988, 96 patients were admitted to the Nagasaki Municipal Medical Center for dialysis therapy of acute renal failure (ARF). The mean age of the patients was 61.1 years, there were 66 males and 30 females, and these accounted for 16.0% of 599 cases including chronic renal failure.
In this study, we evaluated only ARF (78 cases). The patients were grouped into fourteen etiologic categories, i.e., dehydration (22), shock (15), antibiotics (11), hepatorenal syndrome (7), drug intoxication (6), hypercalcemia (3), postoperative (3), contrast medium (2), DIC (2), Weil's disease (2), rhabdomyolysis (2), renal infarction (1), myeloma (1) and RPGN (1).
The renal recovery rate was 72.7% (16/22) in dehydration, 33.3% (5/15) in shock, 72.7% (8/11) in the case of antibiotics and 55.1% (43/78) overall. Survival rates were 63.6%, 26.7%, 36.4% and 43.6%, respectively. Most of these patients had multiple organ failure of the heart, lung, liver, intestine, central nervous system, coagulation and infection. And the total number of organs involved per patient was inversely correlated with renal recovery and survival rate. Among patients with no organ failure, the renal recovery and survival rates were 78.6%, respectively, but in patients with failure of four to six organs the figures were 33.3% and 11.1%, respectively.
These data suggest that complications and multiple organ failure play an important role in the prognosis in acute renal failure.
