[Osmolarity parameter and kidney function of polytraumatized intensive care patients].

Improved possibilities in prediction of renal failure after polytrauma would possibly improve the survival rate of this severe posttraumatic complication. Our clinical investigation was carried out in 27 patients suffering from severe trauma. We intended to achieve early recognition of acute renal failure by osmolality measurements after polytrauma. Thus we investigated the daily concentration of blood urea, serum and urine creatinine, daily urine output, creatinine clearance, plasma and urine osmolality and the serum colloid osmotic pressure. Additional to important informations for fluid and electrolyte replacement the follow-up of osmolality changes in plasma and urine proved general and renal prognostic value. Early and clear decreases in urine-plasma ration, osmolar clearance and negative free water clearance were found in case of later reduction of renal function and acute renal failure. Consequently we advise regular osmolality measurements in the postoperative management of the polytraumatic patient.