Clinical studyA survey of 499 patients with acute anuric renal insufficiency: Causes, treatment, complications and mortality

The records of 499 patients with acute anuric renal failure are reviewed. Among 305 patients with acute tubulo-interstitial nephritis, 205 had a recognized condition of shock and 120 had a severe infection simultaneously. In ninety-two patients with acute tubulo-interstitial nephritis, there was no history of overt shock; presumably infection, hemolysis, anoxia or allergic reaction was the precipitating factor. The mortality is found to rise from 3 per cent in patients with slight or cured underlying disease, to 80 per cent in patients with severe, complicated underlying disease. The mortality increases significantly within the higher age group. The mortality is 34 per cent in patients whose maximum serum urea concentration is less than 300 mg. per 100 ml. but 78 per cent in those whose maximum serum urea concentration is above 500 mg. per 100 ml. Two consecutive groups of patients were compared. One group underwent hemodialysis when the serum urea concentration was approximately 400 mg. per 100 ml. whereas the other group underwent hemodialysis when the serum urea concentration was approximately 300 mg. per 100 ml. No definite difference in mortality was found between these two groups.