Postoperative acute renal failure (PARF) is a potentially lethal complication in the surgical patient. Despite recent advances in dialysis and transplantation, more than half of the patients who develop PAPF die. The severity of the trauma, the
magnitude of the surgical procedure, the gravity of underlying medical conditions that predispose to PARF, and the high incidence of sepsis all contribute to the high mortality Prompt and effective treatment of each component of the multifaceted
etiology of PARF can prevent the syndrome and offers the surgical patient his best chance surviving this frequently fatal organ failure. A clinical study was made on 36 cases of PARF who were admitted to the Dept. of Surg, in Pusan National
University
Hospital from august, 1986 to december, 1990.
@ES The results are as follows:
@EN 1) Male to female ratio was 3.5 : 1, and 20 patients(55.6%) were in 4th and 5th decade.
2) The systolic pressure in 20 patients(55.6%) were under 99 mmHg, and the levels of Hgb in 19 patients(52.7%) were under 9.9 g/dl, and the counts of WBC in 22 pts(61.1%) were abnormal on admission.
3) Oliguric type was 61.1%(22 pts) and nonoliguric type was 38.9%(14 pts). Massive fluid(above 6000 cc per one day) was infused against PARF in 21 pts(58.3%) at one day before development of PARF.
4) I could observe proteinuria in 33 cases(91.7%), glucosuria in 21 cases(58.3%), hematuria in 32 cases(88.9%), and pyuria in 12 cases(33.3%), urine specific gravities in 19 patients(52.7%) were below 1.015. Seurm Na levels in 19 cases(52.7%)
were
below 135 mEq/1, serum K levels in 20 cases(55.6%) were above 5.0 mEq/1. BUN levels in 27 cases(75%) were above 60 mg/dl, and serum creatinine levels in 34 cases(94.4%) were above 2.5 mg/dl.
5) In causes of PARF, traumatic hemoperitoneum was 11 cases(20.6%) GB empyema or acute suppurative cholangitis was 7 cases(10.4%), and intraperitoneal abscess was 6 cases(16.7%).
6) Nephrotoxic antibiotics were injected to 19 patients(52.7%), nonsteroidal antiinflammatory agents were injected to 16 patients(44.4%), and radiographic contrast dyes were used to 4 patients(11.1%).
7) Almost operations were emergency(91.7%), and the amounts of transfusion during operation were above 10 pints in 15 patients(41.7%).
8) Among total 36 cases of PARF, 20 patients(55.6%) were died, and 16 patients(44.4%) were recovered from PARF.
9) Causes of death in PARF were sepsis in 9 cases(25%), ARDS in 4 cases(11.1%), and pulm, edema in 2 cases(5.6%).
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