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To the Editor:—
My experience with the management of acute renal failure has, in general, coincided with the reported experience of Swann and Merrill (Medicine32:215, 1953). Along with these authors, I have taken a conservative attitude toward treatment, with only infrequent resort to any dialysis method, then only to relieve the accumulation of potassium, the most frequent cause of death in patients with lesions that are presumed to be reversible. The various reported methods of dialysis create problems of serious import. The artificial mechanical kidneys entail numerous hazards and, in most hands, operate with uncertain efficiency and considerable expense. Peritoneal lavage requires large quantities of sterile solutions, an abdominal surgical wound, and considerable discomfort for the patient. Gastric lavage also is uncomfortable for the patient and relatively ineffective because of the small dialyzing surface. Lavage of an isolated small intestinal loop has been suggested, but this, again, involves
Lippman RW. ACUTE RENAL FAILURE. JAMA. 1955;157(13):1154-1155. doi:10.1001/jama.1955.02950300082025