THE EFFECTS OF SHOCK ON THE KIDNEY

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Abstract
A review of author''s work and literature. In shock due to decrease in circulating blood volume, such as results from hemorrhage, dehydration, and various types of trauma, the immediate effect on the kidneys is to decrease the renal blood flow. In consequence, excretion may decrease to the point of complete anuria. This condition may continue , for a limited time without organic damage to the kidney; during this period restoration of the general circulation restores normal renal function. If renal ischemia continues sufficiently long, however, the nephrons suffer organic damage affecting chiefly the loop of Henle and the distal tubules, and recovery from shock does not at once restore renal function. Partial or complete renal failure may continue until death results in uremia, or slow recovery of renal function may occur. In the first, circulatory phase of shock kidney, renal failure is attributable chiefly to decreased renal blood flow. In the 2d, organic damage, phase renal failure appears to be attributable to tubular reabsorption of glomerular filtrate. Means that may be taken during shock to forestall organic renal damage, and after shock to favor recovery from such damade, are discussed.
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