To the Editor.—
The article of Dr McMurray et al in the June Archives (138:950-955, 1978) concerning prevailing patterns and predictor variables in patients with acute tubular necrosis states that the prognosis for patients with nonoliguric acute renal failure is better than that for patients with oliguric renal failure.This statement should be called into question. In the period of 1973 to 1977, I have had the opportunity of treating with hemodialysis 70 patients suffering from acute renal failure. The causes in these patients were just as varied as in those of McMurray et al. Eighteen of these patients had a urine output exceeding 400 mL/day. In all cases, creatinine clearance was under 5 mL/min. The mortality among these patients was 50%, not differing substantially from the mortality among the remainder, 54%. Also, Lordon and Burton were not able to correlate survival rate to urinary production in their material.1The
Pederson RS. Patterns and Variables in Patients With Acute Tubular Necrosis. Arch Intern Med. 1979;139(11):1319. doi:10.1001/archinte.1979.03630480091038
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