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May 15, 1996

Acute Renal Failure—A Dangerous Condition

Author Affiliations

From The General Infirmary at Leeds (England).

JAMA. 1996;275(19):1516-1517. doi:10.1001/jama.1996.03530430060041

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