Treatment Principles for acute renal failure

Acute renal failure, is a clinical syndrome, which is caused by a variety of renal excretory function in a short period of time (hours or days) a sharp decline in glomerular filtration rate plunged to less than 5%, resulting in the rapid accumulation of metabolites of the quality of nitrogen and water, electrolytes in the body. Such as the timely diagnosis and treatment of acute renal failure is mostly reversible. The basic principles of the treatment of acute renal failure, treatment of the primary disease, and prevent the occurrence of complications following the principles of treatment measures.
(1) active treatment the incidence of a variety of acute renal failure caused by the primary disease, such as severe trauma, severe infections, should be positive and effective treatment, in particular, hypovolemia, shock, and removal of necrotic tissue.
(2) treatment of oliguria oliguria should be bed rest, treatment focuses on the regulation of water, electrolytes and acid-base balance, the supply of adequate nutrition, strictly limiting the protein intake, as far as possible to complement the high-quality animal protein of high biological value; early preventive hemodialysis or peritoneal dialysis, acute renal failure, infection, bleeding, coma and other complications, but should have a dialysis indications. Water and sodium restriction, should be strictly calculation 24h intake and output, according to daily to 12ml/kg standard supply, or the day urine output plus 500 ~ 600ml as standard supply. Hyperkalemia occurs, the most effective method is hemodialysis or peritoneal dialysis, should be promptly dealt with promptly. Metabolic acidosis, using 5% sodium bicarbonate solution 250ml infusion; 10% calcium gluconate 10ml plus 50% glucose 20ml, intravenous injection of potassium ions to antagonize the myocardial toxicity; 25% glucose solution 200ml plus insulin 16 ~ 20U , intravenous infusion. Fasting high potassium food is strictly prohibited lose banked blood. Strictly limited protein can daily 0.5g/kg supply, and should be appropriate to add the essential amino acids, while allowing heat to be maintained at between 6.6 to 8.7 MJ in order to reduce body protein breakdown.
(3) in urine of treated urine of beginning, the threat to the beginning of complications still exist, the treatment focus is still to maintain water, electrolyte acid-base balance, control azotemia, with particular attention to the dehydration and hypokalemia. Patients can not get up, it should be noted that the lungs and urinary tract infections, strict selection of the minimum renal toxicity of antibiotics. Control of water and diet can be gradually relaxed, the patient may gradually resume a normal diet.
(4) Recovery recovery period, generally no special treatment, mainly according to the different circumstances of the patient, strengthening nursed back to health and the gradual recovery of activity. It should also be regular follow-up of renal function, avoid the use of nephrotoxic drugs.