PROGNOSIS IN POSTTRAUMATIC ACUTE-RENAL-FAILURE IS ADVERSELY INFLUENCED BY HYPOTENSION AND HYPERKALEMIA

Objective: To see if it is possible to predict mortality in isolated p ost-traumatic acute renal failure. Design: Retrospective study 1984-19 90 inclusive. Setting: Teaching hospital, South Africa. Subjects: Thir ty-nine patients who developed isolated post-traumatic acute renal fai lure out of 106526 admissions for trauma. Interventions: Standard aggr essive management of traumatic injury and acute renal failure. Main Ou tcome Measure: Death. Results: Fifteen of the 39 patients who develope d post-traumatic acute renal failure died (39%). Blunt trauma from ass aults was a major cause of acute renal failure (16/39, 41%). Hypotensi on and hyperkalaemia were the two main predictors of death having a mo rtality of 63% and 52%, respectively. Conclusion: Clinicians should be aware of the risks of hypotension and hyperkalaemia in injured patien ts. Preventive measures such as aggressive resuscitation and timely co rrection of serum electrolyte concentrations are essential in such pat ients.