SINCE By waters1 described the features of acute renal failure in 1940, this syndrome has come to be recognized as a major source of morbidity and mortality in the seriously injured patient. Analysis of the battle casualities in the Korean conflict indicated that 33% of the soldiers dying of wounds exhibited gross and microscopic changes of acute renal failure in specimens obtained at autopsy. In spite of numerous attempts, a single agent responsible for the development of acute renal failure has never been clearly identified. The close clinical association of a major hypotensive episode with the subsequent development of renal failure has directed attention to the role of the renal circulation in the pathogenesis of this lesion. It has prompted the impression that agents which increase or maintain renal blood flow in the face of systemic hypotension will offer significant prophylaxis against the development of renal failure.
Dow RW, Fry WJ. Hemorrhagic Shock: Changes in Renal Blood Flow and Vascular Resistance. Arch Surg. 1967;94(2):190–194. doi:10.1001/archsurg.1967.01330080028010
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