Frequency and outcome of patients with acute renal failure have more causes than one in etiology

In literature, there was little data about frequency and outcome of ARF wit h two or more causes in etiology. Therefore, the aim of this study was to s earch this issue. This series included 339 patients with ARF from Jan 1,1987 to Jan 1,1999. F ourty-six (30 males) of all patients (13.5%) had two or more causes in etio logy of ARF. Of these patients, causes were prerenal and renal in 26 (56%), prerenal, renal and postrenal in 12 (26%), renal and postrenal in 4 (9%), and prerenal and postrenal in 4 (9%). The most frequent cause is diarrhea a nd vomiting in prerenal, gentamycin usage in renal and prostat hypertrophy in postrenal. Of these patients, there was oliguria in 32 (70%), anuria in 8 (17%) and non-oliguria in 6 (13%). Treatment modalities of patients was o nly medical in 19 (41%), dialysis in addition to medical therapy in 27 (59% ). In spite of treatment, 5 (10.8) of patients with two or more causes in e tiology died. Causes of death were uremic coma in 2, cardiac disorders in 2 and septic shack in 1. Three (11.2%) of other patients with one cause died . Mortality rates were riot different (chi(2): 0.0298, p > 0.5). Cortical n ecrosis was diagnosed in one patient with multiplee etiology and 2 of other patients. Finally, frequency of ARF with two or more etiologic causes was 13.5%, and most frequent causes were hypovolemia and nephrotoxic drugs. Outcome of the se patients was similar to other patients with one cause.