The clinical and laboratory findings in four cases of acute renal failure following the onset of influenza A viral infection (Port Chalmers/1/73) are presented. Although the pathophysiologic mechanisms affecting the kidney in these cases varied, the ensuing renal failure in each patient was severe. Findings suggestive of acute myoglobinuria developed in one patient, and disseminated intravascular coagulation (DIC) occurred in another. The role of viruses in the pathogenesis of renal disease is reviewed. Despite inconclusive evidence that the influenza virus can cause human renal disease, the secondary pathways that can be triggered by viral infections may be even more significant in producing various degrees of renal dysfunction. The occurrence of renal failure during an episode of influenza represents a serious complication which may influence significantly the morbidity and mortality of patients with this viral infection.
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