Tufts University School of Medicine one liter/day. On day 13, the BUN was 78 mg/dl and the serum creatinine was 3.5 mg/dl. A blood culture grew methicillin-resistant Staphylococcus aureus. Recurrent episodes of bradycardia required placement of a cardiac pacemaker; his blood pressure decreased from 130/80 mm Hg to 100/60 mm Hg. The serum albumin was 1.5 g/dl. The BUN and serum creatinine began to increase again, although he remained nonoliguric with a urine output greater than one liter/day. Urinalysis revealed numerous granular casts and epithelial cells. Urine osmolality was 370 mOsm/liter. The urine contained no white blood cells and an insignificant amount of protein. The BUN and serum creatinine increased to 154 mg/dl and 7.4 mg/dl respectively on the 17th hospital day, and peritoneal dialysis was initiated. The urine output decreased to 10 mI/hr. Peritoneal dialysis was continued until the 36th hospital day. On the 43rd hospital day, the BUN was 28 mgldl and the serum creatinine was 1.2 mg/dl. The hospital course was complicated by anoxic encephalopathy, recurrent sepsis, and respiratory failure. The patient was discharged to his home two months later with a BUN of 10 mg/dl and a serum creatinine of 1.1 mgldl.