THE PERIOD OF SECONDARY OLIGURIA DURING ACUTE RENAL FAILURE

Abstract

THE AIM of the investigation was to reveal specific features of periodization and clinical course of acute renal failure (ARF) of different etiology on the basis of clinico-laboratory analysis of patients with the disease. PATIENTS AND METHODS. 398 patients with ARF were divided into 20 groups by nozological principle. Under study there were the dynamics of general clinical features (diurnal urine excretion, arterial pressure), biochemical indices of blood plasma (concentration of urea, creatinine, bilirubin, sugar, sodium, potassium, calcium and chlorine), indices of the general analysis of urine (urine density and protein concentration in urine) in different periods of ARF. RESULTS. A period of secondary oliguria was detected during ARF which was observed in different groups in 23-29% of the patients and was characterized as absolutely lethal. The development of secondary oliguria was accompanied by progressing aggravation of the general condition of the patients, increased concentration of creatinine in blood plasma and excretion of protein with urine against the background of lessening diuresis and relative weight of urine after a period of polyuria. CONCLUSION. Secondary oliguria is developing due to progressing lesion of renal parenchyma in the period of polyuria, is followed by considerably increased concentration of creatinine in blood plasma, proteinuria and level of intoxication, development of hyposthenuria. The development of secondary oliguria in patients is considered to be a prognostically especially unfavorable factor and requires intensification of medical measures including the methods of extrarenal clearance of blood.