Hodson E M, Kjellstrand C M, Mauer S M
J Pediatr. 1978 Nov;93(5):756-61. doi: 10.1016/s0022-3476(78)81072-5.
Fifty-three children, ages one day to 15 years, were treated with hemodialysis for acute renal failure between 1968 and 1977. Twenty-three had acute tubular necrosis. Nine had ATN associated with catastrophic medical illnesses; all died. Fourteen had ATN following major surgical procedures; ten died. Thirty had ARF due to primary nephrologic disorders; 27 survived. Thus it was not the ARF per se but the underlying and concomitant disorders which had the major influences on survival. As prognostic indications of survival in patients with postoperative ATN cannot be clearly defined, these patients almost always deserve aggressive management, including dialysis therapy. Patients with ATN associated with severe medical illness often have fatal underlying conditions which cannot be influenced by presently available technologies.
1968年至1977年间，53名年龄在1天至15岁的儿童因急性肾衰竭接受了血液透析治疗。其中23名患有急性肾小管坏死。9名急性肾小管坏死患儿伴有严重内科疾病，均死亡。14名急性肾小管坏死患儿继发于大型外科手术后，10名死亡。30名急性肾衰竭患儿由原发性肾脏疾病所致，27名存活。因此，对生存产生主要影响的并非急性肾衰竭本身，而是其潜在及伴随的疾病。由于术后急性肾小管坏死患者的生存预后指标尚无明确定义，这些患者几乎都值得积极治疗，包括透析治疗。伴有严重内科疾病的急性肾小管坏死患者往往存在致命的基础疾病，目前的可用技术对此无法产生影响。
