Post Traumatic Acute Renal Failure

  • Joseph M. Letteri
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 212)


Early references to trauma related acute renal failure were all associated with injury of a crushing type. During the Messina earthquake in 1909, victims crushed by falling masonry almost uniformly died (1). Traumatic uremia was largely overlooked during the First World War despite the high incidence of crushing injuries of trench warfare. Bywaters and Beall in 1941 described the clinical picture of crushing and acute renal failure (2) amongst air-raid casualties during the London blitz.


Acute Renal Failure Parenteral Nutrition Renal Blood Flow Early Dialysis Injured Skeletal Muscle 


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  1. 1.
    S. Minami: Uber Nierenveranderungen nach verschuttung, Arch. Pathol. Anat. 245: 247 (1923).Google Scholar
  2. 2.
    E. G. L. Bywaters and D. Beall: Crush injuries with impairment of renal function, Brit. Med. J. 1: 427 (1941).CrossRefGoogle Scholar
  3. 3.
    P. E. Teschan, C. R. Baxter, T. F. O’Brien, J. V. Freyhof and W. H. Hall: Prophylactic hemodialysis in the treatment of acute renal failure. Ann. Intern. Med. 53: 991 (1960).Google Scholar
  4. 4.
    D. Whelton and J. V. Donadio, Jr.: Post-traumatic acute renal failure in Vietnam. Johns Hopkins Med. J. 124: 95 (1969).Google Scholar
  5. 5.
    R. S. Barsoum, Z. E. B. Rihan, O. K. Bagligh, A. Hozayen, E. G. E1-Ghoneimi, M. F. Ramzy and A.S. Ibrahuim: Acute renal failure in the 1973 Middle East War - experience of a special ized base hospital: effect of site of innury. J. Trauma 20: 303307 (1980).Google Scholar
  6. 6.
    Y. Blachar, J. S. C. Fong, J. P. DeChadarevian and K. N. Drummond: Muscle extract infusion in rabbits: a new experimental model of the crush syndrome. Arc. Res. 49: 114–124 (1981).Google Scholar
  7. 7.
    M. S. Wheby, O. Barrett and W. H. Crosby: Serum protein binding of myoglobin, hemoglobin and hematin. Blood 16: 1579 (1960).PubMedGoogle Scholar
  8. 8.
    S. R. Braun, F. R. Weiss, A. I. Keller, J.R. Ciccone and H. G. Preuss: Evaluation of the renal toxicity of heme proteins and their derivatives: a role in the genesis of acute tubule necrosis. J. Exp. Med. 131: 443 (1970).PubMedCrossRefGoogle Scholar
  9. 9.
    W. A. D. Anderson, D. B. Morrison and E. F. Williams: Pathologic changes following injections of ferrihemate (hematin) in dogs. Arch. Path. 33: 589 (1942).Google Scholar
  10. 10.
    A. C. Corcoran and I. H. Page: Renal damage from ferroheme pigments, myoglobin, hemoglobin, hematin. Texas Reports of Biol. Med. 3: 528 (1945).Google Scholar
  11. 11.
    R. J. Bing: The effect of hemoglobin and related pigments on renal function of the normal and acidotic dog. Bull. Johns Hopkins Hosp. 74: 161 (1944).Google Scholar
  12. 12.
    E. G. L. Bywaters and J. K. Stead: The production of renal failure following injection of solutions containing myohemoglobin. Quart. J. Exp. Physiol. 33: 53 (1946)Google Scholar
  13. 13.
    T. Suzuki and F. K. Mostofi: Electron microscopic studies of acute tubular necrosis. Early changes in the rat kidney after subcutaneous injection of glycerin. Lab. Invest. 28: 8 (1970).Google Scholar
  14. 14.
    J. R. Jaenike: Micropuncture study of methemoglobin-induced acute renal failure in the rat. J. Lab. Clin. Med. 73: 459 (1969).PubMedGoogle Scholar
  15. 15.
    A. Ruiz-Guinazu, J. B. Coelho and R. Paz: Methemoglobin-induced acute renal failure in the rat. In vivo observation, histology and micropuncture of intratubular and post glomerular vascular pressures. Nephron 4:257 (1967).Google Scholar
  16. 16.
    E. S. Finckh: Experimental acute tubular necrosis following subcutaneous injection of glycerol. J. Pathol. Bacteriol. 73: 69 (1957).CrossRefGoogle Scholar
  17. 17.
    G. Ayer, A. Grandchamp and B. Truniger: Intrarenal hemodynamics in glycerol-induced myohemoglobinuric acutre renal failure in the rat. Circ. Res. 29: 128 (1971).PubMedCrossRefGoogle Scholar
  18. 18.
    T. W. Kurtz, R. M. Maletz and C. H. Hsu: Renal Cortical blood flow in glycerol-induced acute renal failure in the rat. Circ. Res. 38: 30 (1976).PubMedCrossRefGoogle Scholar
  19. 19.
    M. F. Chedru, R. Baethke and D. E. Oken: Renal cortical blood flow and glomerular filtration in myohemoglobinuric acute renal failure. Kidney Int. 1: 232 (1972).PubMedCrossRefGoogle Scholar
  20. 20.
    S. Churchill, M.D. Zarlengo, J. F. Carvalho, M. N. Gottlieb and D. E. Oken: Normal renal cortical blood flow in experimental acute renal failure. Kidney Int. 11: 246 (1977).PubMedCrossRefGoogle Scholar
  21. 21.
    C. H. Hsu, T. W. Kurtz and T. P. Waldinger: Cardiac output and renal blood flow in glycerol induced acute renal failure in the rat. Circ. Res. 40: 178 (1977).PubMedCrossRefGoogle Scholar
  22. 22.
    D. E. Oken, M. L. Arce and D. R. Wilson: Glycerol induced hemo globinuric acute renal failure in the rat I. Micropuncture study of the development off oliguria. J. Clin. Invest. 45: 724 (1966).PubMedCrossRefGoogle Scholar
  23. 23.
    G. O’Conner, J. Bardgette, M. Lifschitz, J. Reineck and J. Stein: Sequential studies on the pathophysiology of glycerol induced acute renal failure in the rat. Kidney Int. 12: 531 (1977).Google Scholar
  24. 24.
    J. Mason, C. Olbricht, T. Takabatake and K. Thuran: The early phase of experimental acute renal failure. I. Intratubular pressure and obstruction. Pflugers Arch. 373: 251 (1977).Google Scholar
  25. 25.
    C. Olbricht, J. Mason, T. Takabatake and K. Thuran: The early phase of experimental acute renal failure. II. Tubular leakage and reliability of glomerular markers. Pflugers Arch. 373: 251 (1977).CrossRefGoogle Scholar
  26. 26.
    G. H. A. Clowes, Jr., B. C. George, C. A. Villee, Jr. and C. A. Saravis: Muscle proteolysis induced by a circulating peptide in patients with sepsis or trauma. N. Eng. J. Med. 308: 545–552 (1983).Google Scholar
  27. 27.
    W. H. Horl and A. Heidland: Enhanced proteolytic activity. A use of protein catabolism in acute renal failure. Am. J. Clin. Nutr. 33: 1423 (1980).PubMedGoogle Scholar
  28. 28.
    W. H. Horl, C. Gantert, I. O. Auer and A. Heidland: In vitro inhibition of protein catabolism by alpha2-macroglobulin in plasma from a patient with post-traumatic acute renal failure. Am. J. Nephrol. 2: 32 (1982).PubMedCrossRefGoogle Scholar
  29. 29.
    R. C. May, R. A. Kelly and W. E. Mitch: Metabolic acidosis stimulates protein degradation in rat muscle by a glucocorticoid-dependent mechanism. J. Clin. Invest. 77: 614 (1986).PubMedCrossRefGoogle Scholar
  30. 30.
    W. H. Meroney, G. K. Arney, W. E. Segar and H. H. Balch: The acute calcification of damaged muscle, with particular reference to acute post-traumatic renal insufficiency. J. Clin. Invest. 36: 825–832 (1957).PubMedCrossRefGoogle Scholar
  31. 31.
    F. Llach, A. J. Felsenfeld and M. R. Haussler: The pathophysiology of altered calcium metabolism in rhabdomyolysisinduced acute renal failure. N. Eng. J. Med. 305: 117 (1981).CrossRefGoogle Scholar
  32. 32.
    J. F. Eneas, P. Y. Schoenfeld and M.H. Humphreys: The effect of infusion of mannitol-sodium bicarbonate on the clinical course of myoglobinuria. Arch. Intern. Med. 139: 801 (1979).PubMedCrossRefGoogle Scholar
  33. 33.
    K. Kleinknecht, P. Jungers, J. Chanard, C. Barbanel and D. Ganeval: Uremic and non-uremic complications in acute renal failure: evaluation of early and frequent dialysis on prognosis. Kidney Int. 1: 190 (1972).PubMedCrossRefGoogle Scholar
  34. 34.
    J. D. Conger: A controlled evaluation of prophylactic dialysis in post-traumatic acute renal failure. J. Trauma. 15: 1056 (1975).PubMedCrossRefGoogle Scholar
  35. 35.
    R. M. Abel, C. H. Beck, Jr., W. M. Abbott, J. A. Ryan and G. O. Barnett: Improved survival from acute renal failure after treatment with intravenous essential L-amino acids and glucose. New Engl. J. Med. 288: 695 (1973).Google Scholar
  36. 36.
    S. M. Baek, G. G. Makaboli, C. W. Bryan-Brown, J. Kusek and W. C. Shoemaker: The influence of parenteral nutrition on the course of acute renal failure. Surg. Gynecol. Obstet. 141: 405 (1975).PubMedGoogle Scholar
  37. 37.
    C. D. Leonard, R. G. Luke and R. R. Siegel: Parenteral essential amino acids in acute renal failure. Urology 6: 154 (1975).PubMedCrossRefGoogle Scholar
  38. 38.
    H. Freund, S. Harmian and J. E. Fischer: Comparative studies of parenteral nutrition in renal failure using essential and non-essential amino acid containing solutions. Surg. Gynecol. Obstet. 151: 652 (1980).PubMedGoogle Scholar
  39. 39.
    E. I. Feinstein, M. J. Blumenkrantz, M. Healy, A. Koffler, H. Silberman, S. G. Massry, and J. D. Kopple: Clinical and metabolic responses to parenteral nutrition in acute renal failure. Medicine 6: 124 (1981).CrossRefGoogle Scholar

Copyright information

© Plenum Press, New York 1987

Authors and Affiliations

  • Joseph M. Letteri
    • 1
    • 2
  1. 1.Division of Renal DiseasesNassau County Medical CenterEast MeadowUSA
  2. 2.S.U.N.Y.Stony BrookUSA

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