Prevailing Patterns and Predictor Variables in Patients With Acute Tubular Necrosis

Stephen D. McMurray, MD; Friedrich C. Luft, MD; Douglas R. Maxwell, MD; Richard J. Hamburger, MD; Dennis Futty, MS; James J. Szwed, MD; Kevin J. Lavelle, MD; Stuart A. Kleit, MD
Arch Intern Med. 1978;138(6):950-955. doi:10.1001/archinte.1978.03630310040016.
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The courses of 276 acute tubular necrosis patients referred for dialysis were reviewed in search for prognostic indicators. Sixty-three percent survived. Of 28 possible predictor variables, a posttoxic cause and nonoliguria were favorable, whereas myocardial infarction and peritonitis affected survival unfavorably. Total parenteral nutrition influenced survival favorably only in those with multiple complications or peritonitis. No single variable or combination predicted a lethal outcome. Since survivors were frequently restored to complete health, we advocate an aggressive therapeutic approach even in the face of multiple complications.

(Arch Intern Med 138:950-955, 1978)


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