Treatment of acute renal failure

Treatment of ARF

Treatment of ARF is aimed at the underlying cause. Hypoperfusion of the kidney can be corrected by restoring the arterial volume. Obstruction of the urine outflow can be taken away by surgery or catheterisation. In both situations, renal function returns to normal within days.

Therapy for renal causes of ARF depend on its cause; reduction in blood pressure in hypertensive crisis, methylprednisolone, cyclophosphamide or plasmafereses in acute glomerulonephritis. Interstitial nephritis is also often treated with prednisone. Treatment of ATN is not available.

Recovery of the normal renal function may take up to six weeks, because of the regeneration of damaged tubular cells.

Non-pharmacological treatment is given to prevent complications such as hyperkalemia, hyperphosphatemia, acidosis and uremia. This treatment involves dietary restriction of fluid, salt, potassium, phosphate and protein. In case of complications such as overload, hyperkalemia and acidosis, haemodialysis is required. In intensive care patients renal failure is usually be treated with continuous veno-venous hemofiltration (CVVH).

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An ARF patient receives renal replacement therapy in the form of hemodialysis. What is NOT a target in that respect?