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TREATMENT OF ACUTE RENAL SHUTDOWN

MAURICE B. STRAUSS, M.D.; LAWRENCE G. RAISZ, M.D.
AMA Arch Intern Med. 1955;95(6):846-856. doi:10.1001/archinte.1955.00250120082011.
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WHEN THE occurrence of anuria or oliguria leads to a diagnosis of acute renal shutdown the physician must not only plan appropriate supportive therapy but must at the same time institute any measures which might reverse the process which has led to diminished urine flow. Unless there is virtual certainty that the cause resides within the kidney, investigation of the entire urinary tract is obligatory, since obstructive lesions may occur at any site. Stones as well as neoplasms can obstruct both ureters simultaneously or successively. Persons who, as a result either of disease or of developmental anomaly, have only one functioning kidney will develop apparent acute renal shutdown as the result of obstruction to the sole ureter.1

Dehydration, with or without salt depletion, is one of the commonest causes of oliguria encountered today. Pure water depletion without electrolyte loss generally leads to a concentrated urine. However, when there is

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