Acute renal failure in south India. Our experience with 187 patients.

Abstract

SUMMARY One hundred eight seven patients with acute renal f ailure (ARF) have been studied during the years 1979-84. History, examination, urinary indices, radiology, ultrasound and kidney biopsy were used to determine the aetiology. Acute tubular necrosis (ATN) 73, glomerulo-nephritis (GN) 49, pregnancy-related 17, obstruction 11, leptospirosis 10, drugs 10, snake-b ite 6, septicaemia 5, papillary necrosis 2, obstructive jaundice 2, ma lignant hypertension 1, G-6 PD deficiency 1; were the main aetiological factors encountered. 120 of 187 patients needed dia lysis. 86 were managed by peritoneal dialysis (PD) alone. Only 12 patients needed haemodialysis (HD) from the start. Overall mortali ty 27.8%. It is observed that 1. GN and leptospirosis are important causes of ARF in South India. 2. Copper sulphate induced ARF had a high mortality (76%). 3. Ultrasonography is found to be essential diagnostic aid. 4. Most patients with ARF needing dialysis could be managed by PD alone.