New thoughts on organising medical education.

Abstract

dose modification of Mawer et al23 have not encountered ototoxicity.In managing acute renal failure, we, like most renal units, believe that intensive care, early dialysis, and an aggressive approach to infection provide the basis on which improvements in survival might take place. The mortality of 25% in our series compares favourably with that found elsewhere2 5 19 and partly reflects the good survival attainable in acute renal failure from haemolytic and obstetric causes present in 76% of our cases.Our results justify the establishment of units for managing acute renal failure in tropical Africa. From our analysis of the causes it seems likely that acute renal failure is more comumon in our environment than is generally realised. The comment by Lee24 that the most important factor in recognising acute renal failure is an awareness of the clinical conditions during which it may arise remains a valid one today.We are grateful to Sister Ohene-Ampofo and her staff of the renal unit for skilled dialysis, to the doctors who referred these cases, and to Mr Eugene Kotey for secretarial help. We acknowledge the generous support of the Volta Aluminium Company Ltd and the Masonic Fraternity of Ghana in the establishment of the dialysis unit.