RENAL DAMAGE DUE TO CRUSH INJURY AND ISCHÆMIA OF THE LIMBS OF THE ANÆSTHETIZED DOG
- 22 May 1943
- journal article
- Published by Wiley in Quarterly Journal of Experimental Physiology and Cognate Medical Sciences
- Vol. 32 (1) , 89-106
- https://doi.org/10.1113/expphysiol.1943.sp000877
Abstract
1. A method of crushing the hind limbs and rendering them ischæmic for 4‐5 hours is described which results in impairment of renal function in the anæsthetized dog, and supervenes almost immediately after readmission of circulation to the limbs.2. The renal damage is characterized by a profound reduction in urine flow and in creatinine clearance maintained even when the arterial pressure is restored by intravenous administration of fluids, by a reduction in urine/plasma creatinine concentration ratio, even when the urine flow is unchanged or reduced, and by pigmentation of the urine. The chloride content of the urine is not systematically affected in these experiments.3. P.M. the damaged kidney is flaccid. Microscopic appearance of non‐cellular debris in the proximal convoluted tubule is shown not to be specifically associated with the deterioration in function of the kidney. The loops of Henle and more distal portions of the nephron are dilated and free of debris.4. A number of diuretics were shown to be capable of increasing the urine flow from the damaged kidneys, and concurrently to raise the creatinine clearance, but only to about one‐half its normal value.5. The period of anuria ensuing on readmission of the circulation to the limbs is not an essential antecedent of the renal damage. Lowering the urine flow from damaged kidneys by partial obstruction of the ureter does not enhance the damage.6. The renal damage does not ensue after a considerable period of low arterial pressure maintained by intravenous infusion of histamine into dogs with uninjured limbs.7. The characteristics of the renal damage, due to limb injury, are discussed in relation to the known renal mechanisms likely to be affected, and it is concluded that the disturbance of no single mechanism could account for all the observed phenomena.8. During ischæmia of the limbs the arterial pressure slowly rises and the urine flow is apt to fall off. The urinary chloride content falls and the creatinine clearance often also falls somewhat. These changes may be attributed to increase in sympathetic tone.This publication has 0 references indexed in Scilit: