Renal involvement following near-drowning in the sea

1. The metabolic changes in rats following introduction of sea water directly into the stomach were studied. The results were compared with those of a human case report of acute renal failure following swallowing of sea water. 2. In both rats and man, acute renal failure appeared within the first 24 hr. A slight improvement was found five days later. 3. There was an acute hypocalcemia. This was supposedly due to the large magnesium content of the sea water. 4. It is probable that water entering the alimentary canal, dry drowning, affects the kidneys by the initial flow of water to the intestines. This results in hemo-concentration and reduced kidney function. The abnormality is a transient one and could be due to a partial anoxia due to shrinking of the erythrocytes. 5. It is concluded that an apparently uneventful swallowing of sea water can turn into secondary drowning with transient acute renal failure.