We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Article |

Acute Deterioration in Renal Function [ill]n Patients With Preexisting Renal Insufficiency

[ill] Roy First, MD; Molly Ettenger, MD; Michael Robson, MD; [ill]ictor E. Pollak, MD; Boon Seng Ooi, MD; Martin Goldberg, MD
Arch Intern Med. 1984;144(11):2233-2238. doi:10.1001/archinte.1984.04400020157024.
Text Size: A A A
Published online


[ill] Roy First, MD, Associate Professor of Medicine: Sud[ill]en deterioration in the clinical condition of a patient with [ill]hronic renal insufficiency may occur frequently as a result [ill]f a superimposed acute illness with consequent deteriora[ill]ion in renal function. It is important to identify and treat [ill]ny condition that aggravates the underlying renal disease [ill] has adverse effects on renal function.1

Table 1 illustrates those conditions causing acute deterio[ill]tion of renal function in the patient with azotemia or [ill]emia.1 Reduced renal perfusion commonly results from [ill]xtracellular fluid volume depletion. The use of potent [ill]iuretic agents, eg, furosemide or ethacrynic acid, coupled [ill]ith the injudicious restriction of dietary sodium, is a [ill]mmon cause of salt and water depletion, as are gastroin[ill]stinal (GI) losses of sodium and water by vomiting, [ill]arrhea, or both from intercurrent GI disturbances or [ill]om the uremia per se. Subtle dehydration also may result [ill]hen the patient, who is


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.