{'fraction_non_alphanumeric': 0.026140894993354008, 'fraction_numerical': 0.014621178555604785, 'mean_word_length': 5.433048433048433, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Intensity of Dialysis in Established Acute Renal Failure

Dialysis was initially applied in the late 1940s and 1950s in cases of acute renal failure, where it was discovered to be life-saving in some circumstances. Relatively little attention was paid to the timing or intensity of dialysis at that time, since the procedure was cumbersome, fraught with complications, and not routinely available. As the field of dialytic nephrology progressed and the procedure became more widely available (and supported in the US by the end-stage renal disease program), most attention was directed toward patients with chronic renal failure. The National Cooperative Dialysis Study (NCDS) (1978-1980) was the first large-scale study to investigate the issue of dialysis intensity; it compared long versus short dialysis time, and high versus low time-averaged urea concentration (TAC-urea) in a 2 by 2 factorial design. The NCDS determined that individuals with low TAC-urea experienced significantly fewer hospitalizations, suggesting that more intensive dialysis was associated with reduced morbidity (1) . Subsequent studies confirmed and extended these findings, showing a relationship between dialysis intensity and mortality, even after adjusting for other important risk factors, such as age, sex, race, diabetes, and nutritional status (2, 3). Similar findings have not been observed in acute renal failure. Indeed, most of the published literature on timing and intensity of dialysis for acute renal failure dates to the 1960s and early 1970s. One could argue that the issues of timing and intensity of dialysis are especially important in acute renal failure, since the dialysis procedure itself may influence not only survival, but also the likelihood of renal recovery. Since the advent of renal replacement therapy, nephrologists have observed that urine output usually declines, sometimes precipitously, after the initiation of dialysis. This phenomenon has been attributed to 1) removal of osmotically active compounds such as urea nitrogen which sustain urine output during the predialysis phase, 2) repeated bouts of renal ischemia associated with dialysis-induced hypotension, 3) altered capacity to autoregulate renal blood flow, and 4) activation of