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Medical Author:

John P. Cunha, DO, FACOEP

John P. Cunha, DO, FACOEP

John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Treatment is focused on removing the cause of the kidney failure.

Medications and other products the patient ingests will be reviewed. Any that might harm the kidneys will be eliminated or the dose reduced.

Other treatments will be offered, with the following goals:

• Correct dehydration: Intravenous fluids, with electrolyte replacement if needed
• Fluid restriction: For those types of kidney failure in which excess fluid is not appropriately eliminated by the kidneys
• Increase blood flow to the kidney: Usually related to improving heart function or increasing blood pressure
• Correct chemical (electrolyte) abnormalities: Keeps other body systems working properly

If the patient's kidneys do not respond to treatment, and adequate kidney function does not return, they will need to undergo dialysis. Dialysis is done by accessing the blood vessels through the skin (hemodialysis) or by accessing the abdominal cavity through the lining that encases the abdominal organs (peritoneal dialysis).

• With hemodialysis, the patient is connected to a machine by a tube running from a conduit created surgically between a large artery and vein. Blood is circulated through the dialysis machine (artificial kidney), which removes toxins and wastes. The blood is then returned to the patient's body.
• Most people require hemodialysis three times per week.

With peritoneal dialysis, wastes and excess water from the bloodstream cross into the abdominal cavity (peritoneal space) and are eliminated from the body by coursing through a catheter that is surgically implanted (through the skin) into the peritoneal cavity.

Most people with acute kidney failure improve when the cause of the kidney failure is removed or treated and don't require dialysis. Normal kidney function is usually restored, though in some cases, residual damage only allows partial restoration of the kidney function. Such patients may not require dialysis but may need medicines to supplement lost kidney function.

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