Prolonged Tubular Malfunction Following Acute Oliguric Renal Failure

Abstract

In this report, we present the case history of a patient who developed a brief period of oliguria following acute tubular necrosis. Obstructive uropathy and renal underperfusion were ruled out as etiologic causes of oliguria. While glomerular filtration rate (GFR) returned rapidly toward normal, an unusually prolonged and massive diuresis and saluresis (as high as 45 liters/24 h and 5,700 mEq Na/24 h) ensured for almost 1 month; following this, remission was completed over a matter of days. We believe this case dramatically illustrates the importance of functional maturation of tubules in recovery from acute tubular necrosis, and the protective effect against excess fluid and salt losses afforded by decrease in GFR usually seen in this syndrome.

Acute tubular necrosis (ATN) presenting with an unusually prolonged period of marked polyuria heralded by an abrupt oliguric phase

“…Noteworthy is that this case noted a very short period of oliguria lasting only 24 h followed by marked prolonged polyuria (as high as 45 L in 24 h) 11. The underlying hypothesis in this case was that unusually prolonged and massive diuresis was explained by the short period of oliguria.…”