Effects of Ca-antagonist (nifedipine) on blood pressure responses and renal vascular responses to angiotensin II norepinephrine, vasopressin, bradykinin and prostaglandin E in anesthetized rabbits

Prognosis of 103 patients (65 males and 38 females) with acute renal failure due to 72 medical, 27 surgical and 4 obstetrical causes was examined. Mean age was 49.91.9 (mean SEM). Iatrogenic factors, defined as the administration of aminoglycoside antibiotics, contrast media or other nephrotoxic drugs, and postoperation, accounted for 61.2% of the 103 episodes of acute renal failure. Ninety nine patients except 4 obstetrical cases were devided into 3 groups. The first group was consisted of acute renal failure alone (28 cases), the second one with acute renal failure complicating other organ damage later (23 cases). The third group was consisted of acute renal failure with other organ damage from its onset (48 cases). The mortality rate was 3.6% in the first group, 34.8% in the second group and 68.8% in the third group. Overall mortality in 99 patients was 42.4% and compatible with the other reports. Solitary acute renal failure at the onset and solitary acute renal failure with one organ damage after the onset revealed relatively good prognosis, however, those with more than one organ damage at the onset and two and more organ damage after the onset showed very high mortality. Oliguric acute renal failure due to medical causes had poor prognosis if they had severe liver damage defined by total bilirubin above 3 mg/dl and GPT above 100 U/L. However, postoperative oliguric patients had overall poor prognosis and did not show the similar result as those with medical causes, because they were already complicated with other severe organ damage. This study suggests that the mortality of acute renal failure depends on the cause of acute renal failure, whether it is oliguric or nonoliguric and, moreover, depends on whether the patients with acute renal failure is complicated with other organ damage.