Détail de la notice
Titre du Document
Acute renal failure
Insuffisance rénale aiguë
Acute renal failure (ARF) is usually associated with oliguria (urine output <400 ml/day), increased plasma urea, creatinine and potassium concentrations, acidosis, and ultimately fluid overload In-hospital ARF is most commonly caused by acute tubule necrosis resulting from multiple nephrotoxic insults such as hypotension, sepsis and nephrotoxic drugs In at-risk patients (elderly, diabetics and those with vascular disease, particularly after exposure to angiotensin-converting enzyme inhibitors or radiocontrast), optimise intravascular volume and avoid nephrotoxic drugs Discuss all cases of ARF with a nephrologist Exclude urinary tract obstruction in all patients presenting with ARF Early recognition of rapidly progressive glomerulonephritis (haematuria, urinary red cell casts and features of systemic inflammation), an important cause of ARF developing outside hospital, is crucial since early treatment may prevent the development of end-stage renal failure In established ARF, the immediate priority is to make the patient safe by treating hyperkalaemia and fluid overload Urgent dialysis is indicated in the presence of severe, refractory hyperkalaemia, profound metabolic acidosis, pulmonary oedema and severe uraemia (encephalopathy, pericarditis or bleeding).
Royal College of Physicians
PMID : 11525571 ISSN : 1470-2118
Clinical medicine A. 2001, vol. 1, n° 4, pp. 266-273 [bibl. : 19 ref.]
Pour les membres de la communauté du CNRS, ce document est autorisé à la reproduction à titre gratuit.
Pour les membres des communautés hors CNRS, la reproduction de ce document à titre onéreux sera fournie sous réserve d’autorisation du Centre Français d’exploitation du droit de Copie.

Pour bénéficier de nos services (strictement destinés aux membres de la communauté CNRS (Centre National de la Recherche Scientifique), de l'ESR français (Enseignement Supérieur et Recherche), et du secteur public français & étranger) :