[Topical problems of treatment of acute renal failure in crush syndrome].

The paper analyzes some experience in treating 203 victims with crush syndrome (CS). The victims' status is determined by the force and time of compression, the degree and magnitude of destructive muscular changes, accompanying by lesions and occurring complications. Varying renal dysfunction was revealed in 97 (47.8%) patients, 55 (27%) patients developed mild and severe acute renal failure (ARF) and 38 (18.7%) patients had mild AFR. Renal dysfunction was not detected in 106 (52.2%) patients. The development of severe AFR in CS is a marker of the severity of injury, the body's response to injury and shock; it dictates the tactics of intensive therapy using extracorporeal techniques of detoxification and active or delayed surgical removal of necrotic muscles, which permits prevention of prolonged severe endotoxication and pyoseptic and vital complications. Two-three-week persistent unremoved foci of muscle necrosis and endotoxicosis exhaust the body's adaptive mechanisms, cause severe dysfunction of other organs and systems, promote delayed renal function recovery and ARF resolution.