The presence of crushed, necrotic, and infected tissues in a patient with acute renal failure can enormously complicate the management of the patient's hospital course and, in many cases, can lead to a much more rapid progression of uremia and potassium intoxication. This situation has been abundantly documented in recent years.1-3 While it is generally agreed that necrotic tissue should be immediately debrided in these patients,4,5 it has been noted that at times little benefit seems to accrue from this procedure.4 The following cases are offered as examples of what may be expected of surgery under various circumstances in post-traumatic acute renal failure.
These patients were treated at a specialized treatment center in Korea where casualties who developed post-traumatic renal insufficiency were referred. An artificial kidney was employed as an adjunct in controlling uremia and potassium intoxication. Many of these patients had received massive wounds.