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Persistent High Mortality in Acute Renal Failure: Are We Asking the Right Questions?

Persistent High Mortality in Acute Renal Failure: Are We Asking the Right Questions? Abstract Since the introduction of the artificial kidney by Kolff in the 1940s, increasing numbers of patients with acute renal failure of diverse causes have been treated with this modality. Since Kolff's original model, important advances have occurred in the design of dialysis equipment and supplies to facilitate the ease of dialysis therapy and reduce the complications related to the technical aspects of dialysis. Earlier institution and increased frequency of dialysis have attempted to lessen the accumulation of nitrogenous wastes and other toxic metabolites and have attempted to prevent fluid accumulation and electrolyte disturbances with the intention of reducing the complications of uremia. Greater attention to the metabolic needs of the patient in terms of various forms of enteric or parenteral nutrition have been recommended in an attempt to prevent catabolic wasting, enhance the use of endogenous urea, and hasten the recovery of renal function. Despite these advances, a notable body References 1. Grunfeld JP, Ganeval D, Bournerias F: Acute renal failure in pregnancy. Kidney Int 1980;18:179-191.Crossref 2. Brophy D, Najarian JS, Kjellstrand CM: Acute tubular necrosis after renal transplantation. Transplantation 1980;29: 245-248.Crossref 3. Anderson RJ, Linus SL, Berns AS, et al: Non-oliguric acute renal failure. N Engl J Med 1977;296:1134-1138.Crossref 4. Schrier RW: Acute renal failure: Pathogenesis, diagnosis and management. Hosp Pract 1981;16:93-112. 5. Kjellstrand CM, Ebben J, Davin T: Time of death, recovery of renal function, development of chronic renal failure and need for chronic hemodialysis in patients with acute renal failure. Trans Am Soc Artif Intern Organs 1981;27:45-50. 6. Smith LH, Post RS, Teschan PE, et al: Posttraumatic renal insufficiency in military casualties: II. Management, use of an artificial kidney, prognosis. Am J Med 1955;18:187-198.Crossref 7. Whelton A: Post-traumatic acute renal failure in Vietnam combat injuries: Incidence, morbidity and mortality , in Friedman EA, Eliahou HE (eds): Proceedings of the Conference on Acute Renal Failure , US Dept of Health, Education, and Welfare publication (NIH) 74-608. Government Printing Office, 1973, pp 125-142. 8. Iaina A, Reisen E, Eliahou H: Acute renal failure in combat injuries. J Trauma 1975;15:281-284.Crossref 9. Matas AJ, Payne WD, Simmons RL, et al: Acute renal failure following blunt civilian trauma. Ann Surg 1977;185:301-306.Crossref 10. Shin B, Mackenzie CF, Cowley RA: Changing patterns of post-traumatic acute renal failure. Am Surg 1979;4:182-189. 11. Schuster HP: Acute renal failure after major surgery. Langenbecks Arch Chir 1980;352:489-496.Crossref 12. Welton A, Donadio JV Jr: Post-traumatic acute renal failure in Vietnam: A comparison with the Korean war experience. Johns Hopkins Med J 1969;124:95-105. 13. Alwall N: Therapeutic and Diagnostic Problems in Severe Renal Failure . Copenhagen, Scand University Books, 1963, pp 335-388. 14. Abel RM, Beck CH Jr, Abbott WM, et al: Improved survival from acute renal failure after treatment with intravenous essential L-amino acids and glucose. N Engl J Med 1973;288:695-699.Crossref 15. McMurray SD, Luft FC, Maxwell DR, et al: Prevailing patterns and predictor variables in patients with acute tubular necrosis. Arch Intern Med 1978;138:950-955.Crossref 16. Feinstein EI, Blumenkrantz MJ, Healey M, et al: Clinical and metabolic responses to parenteral nutrition in acute renal failure: A controlled double-blind study. Medicine 1981;60:124-137.Crossref 17. Rainford DJ: Nutritional management of acute renal failure, in Wright PD, Elliot M (eds): Parenteral and Enteral Nutrition. Acta Chir Scand 1981; (suppl 507) , pp 327-329. 18. Swann RC, Merrill JP: The clinical course of acute renal failure. Medicine 1953;32:215-292.Crossref 19. Kraman S, Khan F, Patel S, et al: Renal failure in the respiratory intensive care unit. Crit Care Med 1979;7:263-266.Crossref 20. Multiple organ failure, editorial. Lancet 1977;2:72-73. 21. Routh GS, Mone JG, Briggs JD: Survival from acute renal failure with and without multiple organ dysfunction. Postgrad Med J 1980;56:244-247.Crossref 22. Welt LG: Treatment of lower nephron nephrosis , in Symposium on Shock . US Army Medical Service Graduate School, 1951, chap 28, pp 1-8. 23. Sacks H, Chalmers TC, Smith H: Randomized versus historical controls for clinical trials. Am J Med 1982;72:233-240.Crossref 24. Kennedy AC, Burton JA, Luke RG: Factors affecting the prognosis in acute renal failure. Q J Med 1973;42:73-86. 25. Kornhall S: Acute renal failure in surgical disease with special regard to neglected complications. Acta Chir Scand , 1971, (suppl 419) , pp 5-64. 26. American College of Surgeons Committee on Trauma. Field categorization of trauma patients and Hospital Trauma Index. Bull Am Coll Surg 1980;65:32-33. 27. Goris RJA, Draaisma J: Causes of death after blunt trauma. J Trauma 1982;22:141-146.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Persistent High Mortality in Acute Renal Failure: Are We Asking the Right Questions?

Archives of Internal Medicine , Volume 143 (2) – Feb 1, 1983

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Publisher
American Medical Association
Copyright
Copyright © 1983 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1983.00350020027004
Publisher site
See Article on Publisher Site

Abstract

Abstract Since the introduction of the artificial kidney by Kolff in the 1940s, increasing numbers of patients with acute renal failure of diverse causes have been treated with this modality. Since Kolff's original model, important advances have occurred in the design of dialysis equipment and supplies to facilitate the ease of dialysis therapy and reduce the complications related to the technical aspects of dialysis. Earlier institution and increased frequency of dialysis have attempted to lessen the accumulation of nitrogenous wastes and other toxic metabolites and have attempted to prevent fluid accumulation and electrolyte disturbances with the intention of reducing the complications of uremia. Greater attention to the metabolic needs of the patient in terms of various forms of enteric or parenteral nutrition have been recommended in an attempt to prevent catabolic wasting, enhance the use of endogenous urea, and hasten the recovery of renal function. Despite these advances, a notable body References 1. Grunfeld JP, Ganeval D, Bournerias F: Acute renal failure in pregnancy. Kidney Int 1980;18:179-191.Crossref 2. Brophy D, Najarian JS, Kjellstrand CM: Acute tubular necrosis after renal transplantation. Transplantation 1980;29: 245-248.Crossref 3. Anderson RJ, Linus SL, Berns AS, et al: Non-oliguric acute renal failure. N Engl J Med 1977;296:1134-1138.Crossref 4. Schrier RW: Acute renal failure: Pathogenesis, diagnosis and management. Hosp Pract 1981;16:93-112. 5. Kjellstrand CM, Ebben J, Davin T: Time of death, recovery of renal function, development of chronic renal failure and need for chronic hemodialysis in patients with acute renal failure. Trans Am Soc Artif Intern Organs 1981;27:45-50. 6. Smith LH, Post RS, Teschan PE, et al: Posttraumatic renal insufficiency in military casualties: II. Management, use of an artificial kidney, prognosis. Am J Med 1955;18:187-198.Crossref 7. Whelton A: Post-traumatic acute renal failure in Vietnam combat injuries: Incidence, morbidity and mortality , in Friedman EA, Eliahou HE (eds): Proceedings of the Conference on Acute Renal Failure , US Dept of Health, Education, and Welfare publication (NIH) 74-608. Government Printing Office, 1973, pp 125-142. 8. Iaina A, Reisen E, Eliahou H: Acute renal failure in combat injuries. J Trauma 1975;15:281-284.Crossref 9. Matas AJ, Payne WD, Simmons RL, et al: Acute renal failure following blunt civilian trauma. Ann Surg 1977;185:301-306.Crossref 10. Shin B, Mackenzie CF, Cowley RA: Changing patterns of post-traumatic acute renal failure. Am Surg 1979;4:182-189. 11. Schuster HP: Acute renal failure after major surgery. Langenbecks Arch Chir 1980;352:489-496.Crossref 12. Welton A, Donadio JV Jr: Post-traumatic acute renal failure in Vietnam: A comparison with the Korean war experience. Johns Hopkins Med J 1969;124:95-105. 13. Alwall N: Therapeutic and Diagnostic Problems in Severe Renal Failure . Copenhagen, Scand University Books, 1963, pp 335-388. 14. Abel RM, Beck CH Jr, Abbott WM, et al: Improved survival from acute renal failure after treatment with intravenous essential L-amino acids and glucose. N Engl J Med 1973;288:695-699.Crossref 15. McMurray SD, Luft FC, Maxwell DR, et al: Prevailing patterns and predictor variables in patients with acute tubular necrosis. Arch Intern Med 1978;138:950-955.Crossref 16. Feinstein EI, Blumenkrantz MJ, Healey M, et al: Clinical and metabolic responses to parenteral nutrition in acute renal failure: A controlled double-blind study. Medicine 1981;60:124-137.Crossref 17. Rainford DJ: Nutritional management of acute renal failure, in Wright PD, Elliot M (eds): Parenteral and Enteral Nutrition. Acta Chir Scand 1981; (suppl 507) , pp 327-329. 18. Swann RC, Merrill JP: The clinical course of acute renal failure. Medicine 1953;32:215-292.Crossref 19. Kraman S, Khan F, Patel S, et al: Renal failure in the respiratory intensive care unit. Crit Care Med 1979;7:263-266.Crossref 20. Multiple organ failure, editorial. Lancet 1977;2:72-73. 21. Routh GS, Mone JG, Briggs JD: Survival from acute renal failure with and without multiple organ dysfunction. Postgrad Med J 1980;56:244-247.Crossref 22. Welt LG: Treatment of lower nephron nephrosis , in Symposium on Shock . US Army Medical Service Graduate School, 1951, chap 28, pp 1-8. 23. Sacks H, Chalmers TC, Smith H: Randomized versus historical controls for clinical trials. Am J Med 1982;72:233-240.Crossref 24. Kennedy AC, Burton JA, Luke RG: Factors affecting the prognosis in acute renal failure. Q J Med 1973;42:73-86. 25. Kornhall S: Acute renal failure in surgical disease with special regard to neglected complications. Acta Chir Scand , 1971, (suppl 419) , pp 5-64. 26. American College of Surgeons Committee on Trauma. Field categorization of trauma patients and Hospital Trauma Index. Bull Am Coll Surg 1980;65:32-33. 27. Goris RJA, Draaisma J: Causes of death after blunt trauma. J Trauma 1982;22:141-146.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Feb 1, 1983

References