Figure 816

Changing trends in the causes of acute renal failure (ARF) in the Third-World countries. Trends can be identified from the analysis of medical and obstetric causes by the Chandigarh Study [14]. Chugh and colleagues showed how obstetric (septic abortion) and hemolytic (mainly herbicide toxicity) causes tended to decrease as economic power and availability of hospitalization improved with time. These causes of ARF, however, did not completely disappear. By contrast, diarrheal causes of ARF, such as cholera and other gastrointestinal diseases, remained constant. In conclusion, gastrointestinal causes of ARF will remain important in ARF until structural and sanitary measures (eg, water treatment) are implemented. Educational programs and changes in gynecological attention, focused on controlled medical abortion and contraceptive measures, should be promoted to eradicate other forms of ARF that constitute a plague in Third World countries.

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