Josep Trueta (1897-1977): military surgeon and pioneer investigator of acute renal failure.

The great Spanish military and orthopedic surgeon J. Trueta gained his field and clinical experience in the Spanish civil war (1936-1939) and in Britain during World War II. As part of his major contribution to traumatology, he searched for the causes of the characteristic oliguria of combat casualties. For this purpose he studied the effect of induced ischemic myopathy on renal perfusion in the rabbit. He and his coworkers demonstrated conclusively that in this model there was an extreme renal cortical vasoconstriction with preservation of the medullary circulation. This early first demonstration of posttraumatic vasomotor nephropathy was independently confirmed 20 years later in the USA when 'preferential renal cortical ischemia' was demonstrated in acute renal failure in man. Thus, Trueta discovered in the early 40s the circulatory component of acute renal failure as part of his monumental contribution to military medicine.