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February 12, 1949


JAMA. 1949;139(7):473-474. doi:10.1001/jama.1949.02900240051022

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To the Editor:—  Many measures are currently being advocated for the treatment of acute renal insufficiency. The mechanisms of the renal failure include the various causes of "lower nephron nephrosis" (Lucke, B.: Mil. Surgeon99:371, 1946), mercury poisoning, "reflex anurias," etc. The methods of treatment include peritoneal lavage, various artificial kidneys, perfusion of isolated intestinal loops, etc. The most recent method is that of exchange transfusions (J. A. M. A. 138: 902, 1948). Recovery of the patient is believed due to the replacement therapy; unfortunate results are ascribed to inadequate continuation or repetition of the therapy.Few of the proponents of each specific mode of treatment stress the spontaneous resolution of the anurias. Furthermore, there is no means at present of accelerating the recovery of the injured kidney segment. Any measure available at present may at best tide the patient along to the point of spontaneous recovery.At the

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