[Treatment of acute kidney failure]. / Traitement des insuffisances rénales aiguës.

ABSTRACT

The appropriate treatment of acute renal failure (ARF) is a function of its type and of its underlying causes. Functional ARF requires medical treatment directed towards the correction of kidney hemodynamic disequilibrium and the restoration of adequate glomerular filtration rate (suppression of drugs, correction of hypovolemia, hypotension or shock by vascular refilling and inotropic drug therapy). Obstructive ARF requires restoration of urinary tract patency by urological intervention (internal or external urinary catheter shunt) and treatment of factors underlying the obstruction (lithotomy, steroids, radio and (or) chemotherapy). Organic ARF commonly necessitates referral to a nephrology unit for renal replacement therapy, the choice of treatment modality (hemodialysis, hemofiltration, peritoneal dialysis) depending upon availability and staff expertise as well as patient clinical condition, associated comorbidity and gravity of ARF.