Figure 721

Acute renal failure management. Rao and Friedman [155] compared the course of 146 patients with severe acute renal failure (serum creatinine >6 mg/dL) infected with HIV with a group of 306 contemporaneous persons not infected with HIV but with equally severe acute renal failure. The patients infected with HIV were younger than those in the group not infected (mean age 38.4 and 55.2 years, respectively; P<0.001) and were more often septic (52% and 24%, respectively; P<0.001). Over 80% of patients in each group recovered renal function when conservative therapy alone was sufficient. When dialysis intervention was needed, it was not initiated more often in the group with HIV than in the control group (42% and 24%, respectively; P<0.003). In those patients in whom dialysis was initiated, recovery occurred in about half in each group. Overall, the mortality in patients with severe acute renal failure was not significantly different in those with HIV infection from those in the group not infected with HIV (immediate mortality, 60% and 56%, respectively; mortality at 3 months, 71% and 60%, respectively).

NS— not significant.

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