OLIGURIC RENAL FAILURE: A REPORT OF 400 CASES INCLUDING CLASSIFICATION, SURVIVAL AND RESPONSE TO DIALYSIS

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Abstract
SUMMARY: A brief review is given of the clinical experience of the Renal Unit in 400 consecutive patient admissions for oliguric renal failure over a period of six and a half years. Clinical classification into 13 groups, depending on the circumstances initiating acute renal failure, revealed marked variation in survival (10% to 85%), and the need for and the results of dialysis also varied between groups. The findings support an earlier analysis of 275 cases (Healy et alii, 1963).Ranked in ascending order of survival, the circumstances in which oliguria occurred were: primary renal disease; cardio‐vascular disease; other generalized medical disease; septicæmia; severe burns and trauma (53% of patients, with 10% to 30% survival) ; intra‐abdominal disorders, both medical and surgical (20% of patients, with 50% survival) ; urological procedures and reactions to drugs and chemicals (14% of patients, with 60% survival); and obstetrical cases and blood transfusion reactions (13% of patients, with 85% survival). Classification into such groups, which can be simply made, is valuable in assessing prognosis and the results of treatment.Hæmodialysis and peritoneal dialysis were reserved until severe urmia developed in spite of conservative therapy (60% of cases). Survival was thought to depend on dialysis in 30% of all cases. Frequent or prophylactic dialysis (Easterling and Forland, 1964), when compared with the present series, did not seem to offer significantly better survival rates.

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