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Acute Kidney Failure (cont.)

Acute Kidney Failure Treatment

Treatment of acute renal failure depends partly on the cause and extent of the failure. The patient should be referred to a kidney specialist (nephrologist) for care. The first goal is to pinpoint the exact cause of the kidney failure, as that will partly dictate the treatment. Secondly, the degree to which accumulating wastes and water are affecting the body will impact treatment decisions about medications and the need for dialysis.

Acute Kidney Failure Self-Care at Home

Self-treatment of acute kidney failure is not recommended. Kidney failure can be a very serious condition that requires medical care.

  • It may be possible to receive some or all treatment at home. Treatment in some cases can be administered by a home health nurse under the supervision of a physician.
  • In cases in which recovery of kidney function is incomplete, dialysis, a process by which the blood is cleared of wastes and excess water, is used. Dialysis, when needed for acute renal failure, is performed at a hospital or dialysis center. Home dialysis may be appropriate in cases in which kidney failure is permanent and dialysis is needed indefinitely.
  • Patients with kidney diseases will usually be required to follow a renal diet (kidney diet), that is often low in protein and potassium.

Acute Kidney Failure Medical Treatment

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.

Medically Reviewed by a Doctor on 11/10/2014

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Read What Your Physician is Reading on Medscape

Acute Renal Failure »

Acute renal failure (ARF) or acute kidney injury (AKI), as it is now referred to in the literature, is defined as an abrupt or rapid decline in renal filtration function.

Read More on Medscape Reference »


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