Abstract
Between January 1965 and June 1987, we encountered 170 patients who were treated for acute renal failure by hemopurification. They were divided into four groups in chronological order to investigate changes in their survival rates and organ failure.
Patients in the early periods mainly had medical and gynecologic diseases, and for the most part had one to three failed organs. Patients with more than four failed organs were aged and suffering from surgical diseases, and they increased after 1980. Hemopurification consisted of peritoneal dialysis and hemodialysis in the early periods and changed to hemodialysis plus hemoadsorption in 1980 with a resultant improvement in survival rate from 53% to 76%. However, the survival rate decreased to 68% after 1983, in spite of additional treatment by continuous hemofiltration and plasmapheresis, because of an increase in patients with uncontrolled serious Infections. Futhermore, only 17% of the patients who had multiple organ failure, including kidney, lung and liver, survived in that late period.
As a result, the outcome of our treatment of acute renal failure has chronological improvement as a result of advances in hemopurification and the treatment of shock, and subsequent organ failure. Cooperation among those performing surgery, hemopurification and intensive care in treatment, management and research is necessary to improve survival rates in acute renal failure and background organ failure with uncontrolled serious infection.
