Nonoliguric Acute Renal Failure

To delineate the clinical spectrum of nonoliguric renal failure, we studied prospectively 92 patients with acute renal failure, 54 of whom were nonoliguric throughout their periods of azotemia. Although the causes of nonoliguric renal failure varied, nephrotoxic failure occurred more frequently in nonoliguric than in oliguric subjects (P<0.01). As compared to oliguric patients, those without oliguria had significantly lower urinary sodium concentrations (P<0.05) and fractional excretions of sodium (P<0.02), had a shorter hospital stay (P<0.01), had fewer septic episodes, neurologic abnormalities, gastrointestinal bleeding and acidemia, required dialysis less frequently (P<0.001) and had a lower mortality rate (26 per cent in nonoliguric vs. 50 per cent in oliguric patients — P<0.05). Nonoliguric renal failure occurs more often than is generally recognized and causes less morbidity and mortality than oliguric acute renal failure. (N Engl J Med 296:1134–1138, 1977 Although oliguria is considered a cardinal feature of acute renal failure, nonoliguric acute renal failure has been recognized since 1943.¹ Studies of large series of patients with acute renal failure have emphasized that the nonoliguric form is an unusual variety of acute renal failure that occurs predominantly after burns or traumatic injury,^{2 3 4 5 6 7 8 9 10} particularly when these entities are treated with mannitol.⁵⁷¹¹ More recently retrospective studies have suggested that nonoliguric acute renal failure may account for as much as 20 to 30 per cent of all cases of acute renal failure.^{12 13 14} To clarify the clinical spectrum of nonoliguric acute renal failure, we.