Renal function in burns.

The present study evaluates the evolution of renal function parameters and serum electrolytes in 34 severely burned patients. The population was arbitrarily subdivided in a group with normal renal function (n = 24) and a group with acute renal failure (n = 10), defined by the fact that serum creatinine rose above 2.5 mg/dl at least once. The patient group with normal renal function was characterized by a normal to high creatinine clearance, reaching a consistent peak at day 2 of follow-up. Serum sodium and fractional sodium excretion were low. Further disturbances were a low serum protein, an early hypocalcemia and hypophosphatemia, and a discrete metabolic alkalosis. The patients developing acute renal failure maintained a low fractional sodium excretion. They were in general of older age and had more severe burns than the patients with normal renal function. The survival rate in the patients with acute renal failure was 30%, compared to 75% in the patients, who maintained normal renal function.