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Prevailing Patterns and Predictor Variables in Patients With Acute Tubular Necrosis
Stephen D. McMurray, MD;
Friedrich C. Luft, MD;
Douglas R. Maxwell, MD;
Richard J. Hamburger, MD;
Dennis Futty, MS;
James J. Szwed, MD;
Kevin J. Lavelle, MD;
Stuart A. Kleit, MD
Arch Intern Med. 1978;138(6):950-955.
Abstract
The courses of 276 acute tubular necrosis patients referred for dialysis were reviewed in search for prognostic indicators. Sixty-three percent survived. Of 28 possible predictor variables, a posttoxic cause and nonoliguria were favorable, whereas myocardial infarction and peritonitis affected survival unfavorably. Total parenteral nutrition influenced survival favorably only in those with multiple complications or peritonitis. No single variable or combination predicted a lethal outcome. Since survivors were frequently restored to complete health, we advocate an aggressive therapeutic approach even in the face of multiple complications.
(Arch Intern Med 138:950-955, 1978)
Author Affiliations
From the Department of Medicine, Nephrology Section, and the Department of Medical Genetics, Indiana University School of Medicine, Indianapolis.
Footnotes
Accepted for publication July 26, 1977.
Read in part at the Clinical Dialysis and Transplant Forum, Washington, DC, Nov 21, 1976.
Reprint requests to Indiana University Medical Center, 110 Fesler Hall, 1100 W Michigan St, Indianapolis, IN 46202 (Dr Luft).
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