Recent experience in the management of acute reversible renal insufficiency with oliguria in war casualties has allowed development of methods that should be useful in civilian practice; recommendations are accordingly offered for the management of the major problems of this condition, based on studies of 46 patients who were examined repeatedly by simultaneous clinical, chemical, and electrocardiographic techniques. These patients were all previously healthy young men who had sustained severe trauma, usually with massive blood loss and prolonged shock, and who were resuscitated with difficulty. Although large amounts of whole blood were administered, transfusion reaction was an uncommon cause for renal failure; the only factors common to most of the patients were trauma and shock. These facts should be kept in mind if the methods are applied to civilian patients whose age, physical condition, and degree of trauma are not comparable. It is not the purpose of this report to