FREQUENCY AND OUTCOME OF PATIENTS WITH ACUTE RENAL FAILURE HAVE MORE CAUSES THAN ONE IN ETIOLOGY

In literature, there was little data about frequency and outcomeof ARF with two or more causes in etiology. Therefore, the aim of this studywas to search this issue. This series included 339 patients with ARF from Jan 1,1987 to Jan 1,1999.Fourty-six (30 males) of all patients (13.5%) had two or more causes in etiologyof ARF. Of these patients, causes were prerenal and renal in 26 (56%), prerenal,renal and postrenal in 12 (26%), renal and postrenal in 4 (9%), and prerenaland postrenal in 4 (9%). The most frequent cause is diarrhea and vomitingin prerenal, gentamycin usage in renal and prostat hypertrophy in postrenal.Of these patients, there was oliguria in 32 (70%), anuria in 8 (17%) and non-oliguriain 6 (13%). Treatment modalities of patients was only medical in 19 (41%),dialysis in addition to medical therapy in 27 (59%). In spite of treatment,5 (10.8) of patients with two or more causes in etiology died. Causes of deathwere uremic coma in 2, cardiac disorders in 2 and septic shock in 1. Three(11.2%) of other patients with one cause died. Mortality rates were not different(χ2: 0.0298, p> 0.5). Cortical necrosis was diagnosed in one patient with multiplee etiologyand 2 of other patients. Finally, frequency of ARF with two or more etiologic causes was 13.5%,and most frequent causes were hypovolemia and nephrotoxic drugs. Outcome ofthese patients was similar to other patients with one cause.