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November 1982

Characterization of Acute Renal Failure in the Burned Patient

Author Affiliations

From the Veterans Administration Medical Center (Drs Planas and Henderson) and the Regional Burn Treatment Center, University of California (Drs Wachtel and Frank), San Diego. Dr Planas is a visiting investigator from the Intensive Care Unit, Universidad Autonóma, Barcelona, Spain.

Arch Intern Med. 1982;142(12):2087-2091. doi:10.1001/archinte.1982.00340250045009

• In a retrospective review of 35 patients seen over a twoyear period with second- and third-degree burns of 30% or more of their body surface area, six died within 48 hours. Of the remaining 29 patients, polyuric renal failure developed in ten. The functional pattern of this polyuric renal failure appears to be different from other forms of polyuric acute renal failure inthat fractional excretion of urinary sodium remains low and the urine to plasma osmolality ratio is commonly above unity. This functional pattern is consistent with a reduction in glomerular filtration rate with a proximal tubular defect such that a "downstream" osmotic diuresis occurs. The distal nephron appears to be intact and functioning.

(Arch Intern Med 1982;142:2087-2091)

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