The major cause for the postoperative acute renal failure may be attributed to an incompatible blood transfusion, followed by shock, renal anoxia, the kind of medicine administered and others. It is important to be borne in mind, too, that the patient who has latent renal damage or disposition previously is a most subject of attack to be warded against.
The first symptom to be noted is oliguria or anuria, and its duration is closely connected with prognosis. Abdominal symptoms such as nausea, vomiting and distension are frequently seen, and in the serious cases dyspnea, hypertension, convulsion, coma and even mental disorders may develop.
Obviously the laboratory findings of urine, serum electrolytes and N. P. N. were throughly investigated in the study.
Microscopic observations revealed that the kidney is affected by damages in all parts of the nephrons. These dangers are seen generally at nephritic ducts and interstice. In some instances histological builds of glomerulonephritis were observed.
The diuresis is unobtainable from the damaged kidney, but as that damaged kidney is curable within a several days to a few weeks at the most, the proper care of the patient should be taken to tide over the periodical crisis.
For the first treatment it is necessary that water and serum electrolytes are controled. These controls are sufficient for the cases where kidney damaged is not serious or curable in short time. But for the serious cases dialytic therapy by peritoneal irrigation, or artificial kidney should be adopted.
The peritonea irrigation can easily be manipulated and is generally applied. But the artificial kidney is by far more effective than the irrigation, and for serious acute renal failure it is most preferable.
In preparing dialytic agents careful attention should be paid to its osmotic pressure, and 600 or 700m Os/l is considered adequate. When dialytic therapy is in effective as the last treatment, the ultimate resort would be the transplantation of the kidney.
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