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Wed Dec 20 18:22:26 GMT 2006

In a message dated 12/20/2006 8:26:23 AM Central Standard Time,  
tch at sun.ac.za writes:

The  incidence of chronic renal dysfunction in this group is surprisingly 
small  from what my renal unit colleagues, who follow these patients longterm, 
tell  me. If they reverse the renal dysfunction (usually within around three 
weeks)  they seem to have good functional outcomes with a small group having  
persistant hypertension at five years. the trick is to not let them get  
dehydrated during the inevitable polyuric phase of  recovery.

Tim:

What protocol do your renal chaps use to keep up with the  polyuria? While my 
experience with post traumatic/post crush polyuria is a bit  limited, I did 
train long enough ago that we had frequent episodes of acute post  bladder neck 
obstruction polyuria, something that we don't see as much any more  here in 
the States, due to a combination of more aggressive catheterization, new  
medications to reduce prostate size and a long history of aggressive prostate  
surgery.

Our technique 'back in the day' was to do hourly outputs, and replace 60 to  
70% of the last hour's output with 0.2% saline, with associated dextrose and  
electrolytes (usually D5 1/4 NS with 10 mEq K as citrate or bicarb) over and  
above any needs that the patient otherwise required.

ck
Charles S. Krin, DO FAAFP

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