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ACUTE RENAL INSUFFICIENCY FOLLOWING TRAUMA TO THE ABDOMINAL WALL

Maxwell L. Gelfand, M.D.; Sidney J. Shapiro, M.D.
JAMA. 1953;152(4):319-320. doi:10.1001/jama.1953.63690040003007b.
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Acute renal insufficiency without nephritis has been more readily recognized in recent years. Although described by Minami1 after World War I, it was not clearly understood until World War II, when a number of British investigators2 drew attention to what they thought was a distinctive lesion observed in the kidneys of air raid casualties who came to autopsy after being buried under debris for several hours. They found that the glomeruli were almost completely intact and that the predominant lesion was confined to the lower nephrons. The lower nephrons showed focal degeneration and necrosis of the tubules, with heme casts in the lumens of these tubules. More recently, however, Oliver3 and co-workers have clearly shown not that the lesion is restricted to any specific local area such as the lower nephrons, but that this destructive process may be irregular and may involve the proximal as well as

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