Before the development of renal replacement therapy (RRT), many people with ARF died from severe electrolyte imbalance (hyperkalemia, acidosis) or from the uremic toxins themselves. Patients with ARF are at risk for numerous complications that may lead to death, such as seizures, bleeding, and coma. Since dialysis effectively treats the life-threatening complications of ARF, advanced age and underlying diseases are more likely to determine the risk for a patient's dying from ARF.
Oliguric ARF patients continue to have a high mortality rate, despite the availability of RRT. Almost uniformly, these patients have other acute and/or chronic medical problems. Patients with nonoliguric ARF tend to have a more favorable prognosis and are often easier to treat. Nonoliguric ARF patients often have fewer systemwide complications because their condition typically is caused by drug-related toxicity and interstitial nephritis.