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. 1977 Mar;185(3):301–306. doi: 10.1097/00000658-197703000-00009

Acute renal failure following blunt civilian trauma.

A J Matas, W D Payne, R L Simmons, T J Buselmeier, C M Kjellstrand
PMCID: PMC1396622  PMID: 843128

Abstract

Renal failure developed in 20 patients following blunt civilian trauma. Ten recovered normal renal function; 8 currently survive. Survivors and nonsurvivors did not differ in age, time from trauma to anuria, mean blood urea nitrogen or creatinine level prior to the first or to subsequent dialyses. However, there was an increased incidence of sepsis and liver failure in those who died. When outcome was related to site of injury, patients with closed head injury and/or intra-abdominal injury had a worse prognosis than those with thoracic or extremity injury only. Only 2 patients with perforated bowel survived; both had peritoneal dialysis combined with peritoneal lavage with antibiotic solutions. Mortality in patients with posttraumatic renal failure remains high; however, death is usually a result of associated complications rather than a result of the renal failure. Aggressive management of other complications of the trauma, especially sepsis or potential sepsis, is necessary. We recommend peritoneal dialysis combined with peritoneal antibiotic lavage where there is a potential for posttraumatic intra-abdominal sepsis associated with renal failure.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BALSLOV J. T., JORGENSEN H. E. A survey of 499 patients with acute anuric renal insufficiency. Causes, treatment, complications and mortality. Am J Med. 1963 Jun;34:753–764. doi: 10.1016/0002-9343(63)90084-6. [DOI] [PubMed] [Google Scholar]
  2. BURNETT W. E., BROWN G. R., Jr, ROSEMOND G. P., CASWELL H. T., BUCHOR R. B., TYSON R. R. The treatment of peritonitis using peritoneal lavage. Ann Surg. 1957 May;145(5):675–682. doi: 10.1097/00000658-195705000-00009. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Casali R., Simmons R. L., Najarian J. S., von Haritizsch B., Buselmeier T. J., Kjellstrand C. M. Acute renal insufficiency complicating major cardiovascular surgery. Ann Surg. 1975 Mar;181(3):370–375. doi: 10.1097/00000658-197503000-00020. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Currie D. J. Continuous peritoneal lavage. Surg Gynecol Obstet. 1972 Dec;135(6):951–952. [PubMed] [Google Scholar]
  5. DiVincenti F. C., Cohn I., Jr Intraperitoneal kanamycin in advanced peritonitis. A preliminary report. Am J Surg. 1966 Jan;111(1):147–153. doi: 10.1016/0002-9610(66)90355-2. [DOI] [PubMed] [Google Scholar]
  6. Fischer R. P. High mortality of post-traumatic renal insufficiency in Vietnam: a review of 96 cases. Am Surg. 1974 Mar;40(3):172–177. [PubMed] [Google Scholar]
  7. Gjessing J., Tomlin P. Continuous peritoneal lavage. Acta Chir Scand. 1974;140(2):124–126. [PubMed] [Google Scholar]
  8. Hunt J. A., Rivlin M. E., Clarebout H. J. Antibiotic peritoneal lavage in severe peritonitis. A preliminary assessment. S Afr Med J. 1975 Feb 15;49(7):233–238. [PubMed] [Google Scholar]
  9. Iaina A., Reisin E., Eliahou H. Acute renal failure in combat injuries. J Trauma. 1975 Apr;15(4):281–284. doi: 10.1097/00005373-197504000-00003. [DOI] [PubMed] [Google Scholar]
  10. Kjellstrand C. M., Buselmeier T. J. A simple method for anticoagulation during pre- and postoperative hemodialysis, avoiding rebound phenomenon. Surgery. 1972 Oct;72(4):630–633. [PubMed] [Google Scholar]
  11. Kjellstrand C. M., Casali R. E., Simmons R. L., Shideman J. R., Buselmeier T. J., Najarian J. S. Etiology and prognosis in acute post-transplant renal failure. Am J Med. 1976 Aug;61(2):190–199. doi: 10.1016/0002-9343(76)90169-8. [DOI] [PubMed] [Google Scholar]
  12. Kleinknecht D., Jungers P., Chanard J., Barbanel C., Ganeval D. Uremic and non-uremic complications in acute renal failure: Evaluation of early and frequent dialysis on prognosis. Kidney Int. 1972 Mar;1(3):190–196. doi: 10.1038/ki.1972.26. [DOI] [PubMed] [Google Scholar]
  13. Lordon R. E., Burton J. R. Post-traumatic renal failure in military personnel in Southeast Asia. Experience at Clark USAF hospital, Republic of the Philippines. Am J Med. 1972 Aug;53(2):137–147. doi: 10.1016/0002-9343(72)90124-6. [DOI] [PubMed] [Google Scholar]
  14. McKenna J. P., Currie D. J., MacDonald J. A., Mahoney L. J., Finlayson D. C., Lanskail J. C. The use of continuous postoperative peritoneal lavage in the management of diffuse peritonitis. Surg Gynecol Obstet. 1970 Feb;130(2):254–258. [PubMed] [Google Scholar]
  15. Merino G. E., Buselmeier T. J., Kjellstrand C. M. Postoperative chronic renal failure: a new syndrome? Ann Surg. 1975 Jul;182(1):37–44. doi: 10.1097/00000658-197507000-00008. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. ROSEMOND G. P., GOLDMAN L. I. Management of peritonitis secondary to perforation of the alimentary tract. Surg Clin North Am. 1962 Dec;42:1481–1487. doi: 10.1016/s0039-6109(16)36836-0. [DOI] [PubMed] [Google Scholar]
  17. Rabiner S. F., Drake R. F. Platelet function as an indicator of adequate dialysis. Kidney Int Suppl. 1975 Jan;(2):144–146. [PubMed] [Google Scholar]
  18. Rothenberg S., Silvani H., Chester S., Warmer H., McCorkle H. J. Comparison of the Efficacy of Therapeutic Agents in the Treatment of Experimentally Induced Diffuse Peritonitis of Intestinal Origin. Ann Surg. 1948 Dec;128(6):1148–1163. [PMC free article] [PubMed] [Google Scholar]
  19. SCHATTEN W. E. Intraperitoneal antibiotic administration in the treatment of acute bacterial peritonitis. Surg Gynecol Obstet. 1956 Mar;102(3):339–346. [PubMed] [Google Scholar]
  20. SCHUMER W., LEE D. K., JONES B. PERITONEAL LAVAGE IN POSTOPERATIVE THERAPY OF LATE PERITONEAL SEPSIS. PRELIMINARY REPORT. Surgery. 1964 Jun;55:841–845. [PubMed] [Google Scholar]
  21. Stone W. J., Knepshield J. H. Post-traumatic acute renal insufficiency in Vietnam. Clin Nephrol. 1974 Sep-Oct;2(5):186–190. [PubMed] [Google Scholar]
  22. Stott R. B., Cameron J. S., Ogg C. S., Bewick M. Why the persistently high mortality in acute renal failure. Lancet. 1972 Jul 8;2(7767):75–79. doi: 10.1016/s0140-6736(72)91562-0. [DOI] [PubMed] [Google Scholar]
  23. Webel M. L., Ritts R. E., Jr, Briggs W. A., Light J. A. Lymphocyte blastogenesis in patients receiving hemodialysis. Arch Intern Med. 1976 Jun;136(6):682–687. [PubMed] [Google Scholar]

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