American Journal of Clinical Nutrition, Vol 4, 486-496, Copyright © 1956 by The American Society for Clinical Nutrition, Inc.

Dietary Treatment in Acute Anuria

¹ Lecturer in Medicine, University of St. Andrews, Scotland
² Holder of Traineeship from the National Heart Institute of the National Institutes of Health, U. S. Public Health Service

Immediate diagnosis and treatment are urgent matters in anuria. Extra-renal factors depressing renal blood flow should be corrected. Ureteral catheterization may be required for obstructive anuria, but judgment in the selection of cases is necessary.

Dietetic management should begin as soon as the diagnosis of anuria is established. Endogenous protein breakdown is kept to a minimuum by high calorie, protein-free diet administered orally, by gastric tube, or intravenously. The patient is kept in meticulous water and sodium balance, and symptomatic acidosis and alkalosis are treated by an appropriate mixture of sodium salts when these are required to balance sodium output. Hyperkalemia is treated by giving sodium-charged cation exchange resin either orally or by retention enemas.

Even when spontaneous diuresis occurs, meticulous water and electrolyte balance and protein restriction must be continued until the blood urea nitrogen level approaches normal.

The patient is isolated and given antibiotics throughout the illness to prevent infection.

In some cases dialysis procedures are required in addition to the dietary regimen.