Acute renal failure: a study of the course and prognosis of 104 patients and of the role of furosemide.

The course and outcome of 104 patients with acute renal failure were studied. Nephrotoxic drugs emerged as the second commonest cause of this disease. Overall mortality was 57 per cent; surgery, age, and sex had no significant effect on it. The mortality in the group caused by nephrotoxic drugs (36 per cent) was significantly lower than that in the groups caused by hypovolemic shock (64 per cent), cardiogenic shock (77 per cent) or arrhythmia (80 per cent). Oliguria was not observed in 25 per cent of patients; in this group mortality was lower (38 per cent) than in the oliguric group (62 per cent). The development of congestive heart failure and ascites adversely affected the outcome. Furosemide administration resulted in a sustained diuresis in 22 per cent, and transient diuresis in 14 per cent of patients. Except for a significant reduction in the need for dialysis, furosemide had no other salutary effect.