A cation-exchange resin artificial kidney: development and metabolic studies.

are relatively few, and generally are related to either inadvertent transfusion of incompatible blood or the outcome of some severe form of injury. The latter may follow a surgical operation or be the result of massive trauma incurred during combat. The consequent renal insufficiency is often temporary in nature, and efforts are directed at prolongation of life by sustaining the patient through a critical phase of profound physiologic disturbances until secretion of urine is again resumed. During World War IS, it was not infrequent for individuals who suffered burial under debris or crushing-type injuries to develop anuria. Autopsy of such casualties during the bombardment of London disclosed that the renal dysfunction was due to necrosis of the renal tubules-that is, of the epithelial part of the nephron, whereas the glomeruli were intact.l Similar histologic changes appear to occur in many other instances of acute anuria, such as those accompanying shock or incompatible blood transfusions. St has become appreciated that the primary pathologic lesion in such states is a tubular one, and that acute anuria due to tubular necrosis is a reversible process, unless there is concomitant extensive glomerular That treatment should be aimed toward obtaining a survival interval of approximately two weeks after the onset of anuria was recognized particularly in the Mediterranean Theater of Operations in