The high mortality of acute renal failure associated with ruptured abdominal aortic aneurysm continues to plague surgeons. In spite of encouraging reports of increased survival of acute renal failure associated with other clinical situations, the failure to improve survival in this group of patients is disappointing.
Abbott and co-workers (see page 1110) describe yet another attempt to improve survival in this dismal group of patients, unfortunately without apparent success. In a group of 32 patients who developed renal failure following ruptured abdominal aortic aneurysm the survival was only 12.5%. The present authors were encouraged to attempt more aggressive nutritional therapy following the report of Abel concerning improved survival from acute renal failure after intravenous treatment with essential L-amino acids and glucose. Although their total group of patients had a significantly greater survival with the improved nutritional therapy, the subgroup of patients who developed renal failure following ruptured aortic aneurysms showed