Endotoxinaemia and the pathogenesis of acute renal failure.

A study has been made by Limulus assay of the incidence of endotoxinaemia in renal disease: positive results were found in 12/16 patients at the onset of acute renal failure. Results are supported by those of a platelet nitroblue tetrazolium reduction assay. In individual cases increased fibrinogen catabolism has been linked to substantial endotoxin levels. The assay can evaluate endotoxinaemia as a cause of acute renal failure and also detect secondary infection. Shwartzman equivalents appear to account for most cases of acute renal failure in man.