Renal failure in the trauma patient.

Acute renal failure is a serious complication of the resuscitation and post-traumatic critical care of the severely injured patient. Renal ischemia secondary to shock is the most common cause of post-traumatic renal failure. The unrecognized or untreated renal ischemic state can lead to nephrotoxic damage in the post-traumatic patient. Prevention of acute failure by rapid resuscitation and restoration of circulating volume to prevent ongoing renal ischemia and prerenal azotemia is imperative for reducing the incidence of post-traumatic renal failure. Once post-traumatic renal failure is established, aggressive dialysis can reduce the mortality resulting from post-traumatic renal failure.