Crush injuries with impairment of renal function

Abstract

Four cases of crush injury to limbs, producing shock, are described in which after recovery due to replacement of circulatory fluid the patients showed oliguria and pigment casts. They died in about one week with nitrogen retention. Necropsy revealed degenerative changes in the proximal convoluted tubules and pigment casts in the more distal part of the nephron. The aetiology and possible lines of treatment are discussed. We are grateful to our colleagues engaged on shock research at the British Postgraduate Medical School for their cooperation and participation in this study - in particular to Prof. Dible and Dr. Thomas Belt, and to Dr. J. Clegg, who supplied the serum. Our thanks are also due to the Chief Medical Officer of the London County Council for permission to publish this report.