Abstract
Acute renal failure is a rare complication in patients with acute traumatic paraplegia but should be considered as a possibility when there is severe tissue damage or considerable blood loss in the patient. A case is described in which the diagnosis of acute renal failure was made on the basis of azotaemia and hyper-kalaemia 48 hours after the injury. It is suggested that if the urine output had been frequently examined during this period it is likely that renal impairment would have been diagnosed much earlier and attempts could have been made to abort renal failure. The determinants of an ‘adequate’ urine output in both normal subjects and injured patients (particularly those with acute traumatic paraplegia) are discussed at length.
Similar content being viewed by others
Article PDF
References
Bors, E & Comarr, A E (1971). Neurological Urology, p. 352. Basel: S. Karger.
Brun, C (1954). Acute Anuria. Copenhagen.
Bywaters, E G L (1944). Ischemic muscle necrosis, crushing injury, traumatic edema, the crush syndrome, traumatic anuria, compression syndrome: A type of injury seen in air raid casualties following burial beneath debris. J. Amer. Med. Asso. 124, 1103.
Cason, J S (1966). Treatment of renal failure. Transactions of the Second International Congress on research in burns, Edinburgh 20th-24th Sept. 1965, p. 12 (Eds. A. B. Wallace & A. W. Wilkinson). Edinburgh: Livingstone.
Eisen, V D & Lewis, A A G (1954). Antidiuretic activity of human urine after surgical operations. Lancet, 2, 361.
Gamble, J L (1958). Extracellular Fluid, 6th Edn. Cambridge, Massachusetts: Harvard University Press.
Joekes, A M, Mowbray, J F & Dormandy, K (1957). Oliguria with urine of ‘fixed' specific gravity. Lancet, 2, 864.
Le Quesne, L P & Lewis, A A G (1953). Post-operative water and sodium retention. Lancet, 1, 153.
Loughridge, L W, Milne, M D, Shackman, R & Wootton, I D P (1960). Clinical course of uncomplicated acute tubular necrosis. Lancet, 1, 351.
Moore, F D (1960). Solute diuresis as a therapeutic aspect of the burn physiology. p. 101. Proceedings of the 1st Int. Congr. in Burns, Bethesda, Maryland, 19th to 22nd Sept. 1960. Ed. C. P. Artz. Philadelphia: F. A. Davis Co.
Parsons, F M (1971). Director, Renal Research Unit, Leeds General Infirmary. Personal communication.
Parsons, F M, Hobson, S M, Blagg, C R & Mccracken, B H (1961). Optimum time for dialysis in acute renal failure. Lancet, 1, 129.
Perlmutter, M, Grossman, S L, Rothberg, S & Dobkin, G (1959). Urine-serum urea nitrogen ratio (simple test of renal function in acute azotemic oliguria). J. Amer. Med. Ass., 170, 1533.
Settle, J A D (1971). Urine output following severe burns. M.Phil. Thesis (Leeds).
Shen, S C, Ham, T H & Fleming, E M (1943). Studies on the destruction of red blood cells. III. Mechanism and complications of hemoglobinuria in patients with thermal burns. New Engl. J. Med. 229, 701.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Settle, J. Renal osmolal output of patients with acute traumatic paraplegia. Spinal Cord 10, 227–231 (1972). https://doi.org/10.1038/sc.1972.40
Issue Date:
DOI: https://doi.org/10.1038/sc.1972.40