Acute renal failure in the 1973 Middle East war--experience of a specialized base hospital: effect of the site of injury.

All battle casualties admitted to a specialized base hospital were surveyed for early signs of acute renal failure (ARF), and diuresis was induced in high-risk subjects. Sixty of 1.147 cases developed ARF. Statistical analysis showed that ARF was more frequently observed with multiple injuries, as well as with single injuries of the abdomen, proximal lower limb, and the head and cervical spine. These were therefore considered as critical sites of injury. The relation of urine output, incidence of septic complications, and mortality rate to the site(s) and multiplicity of trauma is discussed, along with the probable mechanism(s) of ARF following each of the critical injuries.