Acute renal failure due to acute diarrhoeal diseases

Fifty four patients with acute renal failure (ARF) due to acute diarrhoeal diseases (ADD) were treated between August 1987 and May 1988. There were 39 males and 15 females. The mean age was 46.25 years. These patients were referred by general practitioners (GP's) and private nursing homes during an epidemic of ADD in Madras city in 1987-'88. Investigations revealed plasma urea (mean +/- SD) 129 +/- 52.8 mg/dl. and plasma creatinine (mean +/- SD) 7.51 +/- 4.3 mg/dl. 42 patients underwent peritoneal dialysis. 3 had haemodialysis. 29 patients died (mortality, 53.7%). The most significant factor for high mortality was the time interval from onset of ADD to diagnosis of ARF which was 5.2 +/- 2.17 days in the patients who survived compared to 8.5 +/- 3.1 days in the patients who died (P less than 0.01). It is concluded that (a) GP's had given inadequate fluid therapy before admission and (b) were initially not aware of renal failure and so referred them late to hospital.