McMurray S D, Luft F C, Maxwell D R, Hamburger R J, Futty D, Szwed J J, Lavelle K J, Kleit S A
Arch Intern Med. 1978 Jun;138(6):950-5.
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 pareneral 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.
对276例因急性肾小管坏死而接受透析治疗的患者病程进行了回顾，以寻找预后指标。63%的患者存活。在28个可能的预测变量中，中毒后病因和非少尿是有利因素，而心肌梗死和腹膜炎则对存活产生不利影响。全胃肠外营养仅对有多种并发症或腹膜炎的患者存活有有利影响。没有单一变量或变量组合能够预测致死结局。由于存活者常常完全康复，因此即使面对多种并发症，我们仍主张采取积极的治疗方法。
