THE TREATMENT of anuria and oliguria has received increasing attention in the past few years, probably as a result of the introduction of the sulfonamides and because of the occurrence of shock and blood transfusion reactions in the past war. The mortality associated with acute suppression of the urine has been high in the past, ranging from 20 to 50 per cent. A good part of this mortality has been due to poor management, probably resulting in a large measure from misunderstanding concerning the basic physiological principles involved.
Acute suppression of the urine may be the result of (1) mechanical blockage, (2) dehydration, (3) action of poisons on the kidneys, (4) lower nephron nephrosis or (5) hepatorenal syndrome. Mechanical blockage to the outflow of urine is most commonly caused by stones or sulfonamide crystals and has received emphasis for some time from the urologists. The lower nephron nephrosis type of