AN INTEREST in the use of the artificial kidney has provided us with an opportunity for management of a number of patients with acute renal failure. In seven instances the acute renal failure followed intravascular hemolysis associated with a coincidental surgical procedure. This combination provides two important factors which portend a severe type of acute renal failure. Management of these seven patients has included conservative methods of fluid restriction and rigid electrolyte management. In two instances replacement transfusions were done 8 and 16 hours following the hemolytic reaction, and surgery was performed in an effort to remove the products of intravascular hemolysis. Dialysis with the artificial kidney was undertaken in four patients as an adjunct to conservative management. This report is concerned with the experience with these seven patients with hemolytic reactions associated with surgical procedures.
PHASES OF RENAL FAILURE
There are three phases of renal failure following a hemolytic