This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Ellison, D. H. Articles by Bia, M. J. Search for Related Content PubMed Articles by Ellison, D. H. Articles by Bia, M. J. Social Bookmarking                         What's this?

Acute Renal Failure in Critically Ill Patients

Margaret Johnson Bia, MD

Division of Nephrology, 2074 LMP, Yale University School of Medicine, 333 Cedar St, New Haven, CT 06510

Acute renal failure is an important cause of morbidity in critically ill patients. Acute renal failure results from pre renal and postrenal causes and, most importantly, acute tubular necrosis (ATN). Although it is known that renal toxins and renal ischemia are the most common causes of ATN in hospitalized patients, the exact pathogenesis of this entity is still not fully understood. Patients in the intensive care unit are at high risk for ATN because of hemodynamic instability, the administration of neph rotoxic antibiotics or chemotherapeutic agents, and ex posure to radiographic contrast agents. The acquired immunodeficiency syndrome is also associated with an increased risk of renal failure development, either from complications of the disease itself or from its treatment. Many consequences of acute renal failure such as vol ume overload, acidosis, hyperkalemia, and serositis can be managed adequately with peritoneal dialysis, hemo dialysis, or a newer technique, continuous arteriove nous hemofiltration. Despite improvements in treat ment, however, the mortality of ATN remains high. In this review, we recommend measures to prevent ATN in certain clinical situations that commonly occur among critically ill patients. We also review therapeutic options for treating patients in whom acute renal failure devel ops and discuss newer developments that may begin to reduce the excessive morbidity associated with ATN.

Journal of Intensive Care Medicine, Vol. 2, No. 1, 8-24 (1987)
DOI: 10.1177/088506668700200104


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?