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Metabolic Problems Related to Prolonged Dialytic Maintenance of Life in Oliguria

John F. Maher, M.D.; George E. Schreiner, M.D.
JAMA. 1961;176(5):399-403. doi:10.1001/jama.1961.03040180001001.
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Hemodialysis has maintained some patients with acute renal failure through periods of extreme catabolism and prolonged oliguria. Of 37 patients who survived with the aid of 1 to 6 hemodialyses, the duration of oliguria ranged from 7 to 34 days, and among patients who did not survive one was maintained for 181 days despite true oliguria. Metabolic problems that arise under these conditions include defective wound healing, crystallization of oxalates in the renal parenchyma, a general decline in the nitrogenous fractions of endogenous metabolism, an abnormal amino acid pattern, and nutritional deficiences. Data from a number of cases illustrate the problems that need to be solved when a patient is maintained through a prolonged period of oliguria.


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