clinical course

Last reviewed 01/2018

Three phases are described:

• initiating - the interval between injury and the development of renal failure that cannot be reversed by the treatment of the initiating event.

• maintenance - a phase of oliguria in which urine output may fall to 40 - 400 ml per day. There is resultant salt and water overload, potassium retention i.e. hyperkalaemia, elevation in blood urea nitrogen and creatinine, and metabolic acidosis. Careful management of the patient's water and electrolytes is necessary.

• recovery - urine output increases up to 3 l per day. The patient is no longer oliguric. However, losses of sodium and potassium may be large. Hypokalaemia may develop. Blood urea and creatinine return to normal. Eventually, there is usually full recovery of tubular concentrating ability and urine concentrating ability.