Thursday, December 9, 2010

Treatment for Acute Renal Failure ARF

Preventive Measures

  • Identify patients with preexisting renal disease.
  • Initiate adequate hydration before, during, and after any procedure requiring NPO status.
  • Avoid exposure to nephrotoxins. Be aware that the majority of drugs or their metabolites are excreted by the kidneys.
  • Monitor chronic analgesic use some drugs may cause interstitial nephritis and papillary necrosis.
  • Prevent and treat shock with blood and fluid replacement. Prevent prolonged periods of hypotension.
  • Monitor urinary output and CVP hourly in critically ill patients to detect onset of renal failure at the earliest moment.
  • Schedule diagnostic studies requiring dehydration so there are rest days, especially in aged who may not have adequate renal reserve.
  • Pay special attention to draining wounds, burns, and so forth, which can lead to dehydration and sepsis and progressive renal damage.
  • Avoid infection; give meticulous care to patients with indwelling catheters and I.V. lines.
  • Take every precaution to make sure that the right person receives the right blood to avoid severe transfusion reactions, which can precipitate renal complications.

Corrective and Supportive Measures

  • Correct reversible causes of acute renal failure (eg, improve renal perfusion; maximize cardiac output, surgical relief of obstruction).
  • Be alert for and correct underlying fluid excesses or deficits.
  • Correct and control biochemical imbalances treatment of hyperkalemia.
  • Restore and maintain blood pressure.
  • Maintain nutrition.
  • Initiate hemodialysis, peritoneal dialysis, or continuous renal replacement therapy for patients with progressive renal failure and other life-threatening complications.

Patient teaching & home health guidance for patient with renal failure acute

  • Explain that the patient may experience residual defects in kidney function for long period after acute illness.
  • Encourage reporting for routine urinalysis and follow-up examinations.
  • Advise avoidance of any medications unless specifically prescribed.
  • Recommend resuming activity gradually because muscle weakness will be present from excessive catabolism.


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