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ARTICLE |

Acute Renal Failure—A Dangerous Condition FREE

John H. Turney, MA, MD, FRCP
[+] Author Affiliations

Reprints: John H. Turney, MA, MD, FRCP, The General Infirmary at Leeds, Great George Street, Leeds LS1 3EX, England.


JAMA. 1996;275(19):1516-1517. doi:10.1001/jama.1996.03530430060041
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Acute renal failure is the most serious and most expensive renal disorder in medical practice and appears to be increasing in frequency. From its earliest recognition,1 it has been clear that severe renal dysfunction carries a heavy mortality rate, but only recently has it been recognized that apparently small decreases in renal function exacerbate the mortality of the underlying condition. Despite developments in treatment, the overall mortality rate from acute renal failure has not substantially altered in the past 40 years.2 The apparent lack of improvement in outcome obscures the fact that the patients with acute renal failure in the 1990s are very different from their predecessors; they are substantially older, have significant comorbid conditions, and very frequently have multiple organ failure. Nephrologists like to believe that the treatment is getting better but the state of the patients they are called in to treat is getting worse and

REFERENCES

 Hippocrates of Cos. Aphorisms. VI:44. In: Lloyd GER, ed. Hippocratic Writing . London, England: Penguin Books Ltd; 1978;.
Turney JH.  Outcome in acute renal failure.  In: Raine AEG, ed. Advanced Renal Medicine . Oxford, England: Oxford University Press; 1992;:314-324.
Levy EM, Viscoli CM, Horwitz RI. The effect of acute renal failure on mortality: a cohort analysis. 1996;275:1489-1494.
Brenner BM. The Kidney . 5th ed. Philadelphia, Pa: WB Saunders Co; 1996;.
Hakim R, Wingard RL, Parker RA.  Effect of the dialysis membrane in the treatment of patients with acute renal failure. N Engl J Med . 1994;;331:1338-1342.
Bellomo R, Ronco C.  Acute renal failure in the intensive care unit: adequacy of dialysis and the case for continuous therapies. Nephrol Dial Transplant . 1996;;11: 424-428.

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 Hippocrates of Cos. Aphorisms. VI:44. In: Lloyd GER, ed. Hippocratic Writing . London, England: Penguin Books Ltd; 1978;.
Turney JH.  Outcome in acute renal failure.  In: Raine AEG, ed. Advanced Renal Medicine . Oxford, England: Oxford University Press; 1992;:314-324.
Levy EM, Viscoli CM, Horwitz RI. The effect of acute renal failure on mortality: a cohort analysis. 1996;275:1489-1494.
Brenner BM. The Kidney . 5th ed. Philadelphia, Pa: WB Saunders Co; 1996;.
Hakim R, Wingard RL, Parker RA.  Effect of the dialysis membrane in the treatment of patients with acute renal failure. N Engl J Med . 1994;;331:1338-1342.
Bellomo R, Ronco C.  Acute renal failure in the intensive care unit: adequacy of dialysis and the case for continuous therapies. Nephrol Dial Transplant . 1996;;11: 424-428.
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To understand the clinical management of acute heart failure syndromes.
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