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April 1974

Postoperative Renal Failure in the 1970s: A Continuing Challenge

Author Affiliations

Marshfield, Wis
From the departments of thoracic and cardiovascular surgery (Drs. Ray, Myers, and Sautter) and nephrology (Drs. Winemiller and Parker), Marshfield Clinic, and Marshfield Clinic Foundation for Medical Research and Education, Marshfield Clinic (Mr. Wenzel), Marshfield, Wis.

Arch Surg. 1974;108(4):576-583. doi:10.1001/archsurg.1974.01350280176029

From Jan 1, 1970, through June 30, 1973, 18 surgical patients developed acute postoperative renal failure (APORF). Nine had undergone cardiac surgery; four, abdominal aneurysm resection; four, emergency gastrointestinal tract surgery; and one excision of an adrenal cyst. Eleven died and seven lived. Two patients did not need hemodialysis and both lived. Sixteen underwent hemodialysis with five survivors. Operative and postoperative diuretics were administered to 14. In eight of the 11 deaths APORF was judged a major factor leading to death. Specific forms of improved patient management may have reduced morbidity and possibly mortality in 14 patients. The benefits of diuretics, used operatively and postoperatively to assure prevention of APORF, seems unclear. The mortality of 61% is compelling argument for seeking alternate and improved methods for preserving renal function during and after surgery.