Use of the artificial kidney; its place in the treatment of acute renal failure.

Of 57 patients with severe, but potentially reversible, acute renal failure who were observed during a recent four-year period, some had dialysis with an artificial kidney and some did not. Twenty survived with the standard "conservative" management alone; 19 survived with a combination of "conservative" and "intensive" (that is, artificial kidney) treatment; 18 patients died. One error that was made in the management of all 18 patients who died, was excessive delay in the use of the artificial kidney. Hemodialysis should be used whenever serious electrolyte abnormality exists, whenever the blood urea nitrogen exceeds 150 mg. per 100 cc. or whenever clinical signs of uremia first appear. One or more of these indications will usually, but not always, become evident between the fifth and the eighth day of virtual anuria.