Microscopic assays regarding the renal damage following a post-combustional shock

Over a period of three years (2000-2003) 39 autopsies were performed on patients with burns. Among them a number of 11 men and 28 women were aged between 28-92 years, the total burnt body surface was of 20% to 95%. Of all the cases nine patients died during the first 24-36 hours since the accident happened, presenting a burnt surface of more than 70%. In these cases, the renal lesions were minor but critical, presenting symptoms of acute renal failure (ARF). Subsequently, a number of 25 patients died within 1-4 weeks since the accident. Renal lesions were complex with tubular necrosis, lymphocyte infiltration and micro-abscesses. The burnt body surface of these patients was of 41-85%. In three cases, when death occurred within four weeks of hospitalization, the patients presented damages to other organs as well (multiple organs failure--MOF). The kidneys displayed tubular necrosis, fibrous micro-thrombi and infarct areas. In two cases coagulation intravascular dissemination occurred in patients with burnt body surface of 45-70% and aged of 42 and 60 years. Micro-thrombi and infarct areas dominated the renal lesions.