Renal failure, acute, treatment

Ulinski T, Guigonis V, Dunan O, Bensman A. Acute renal failure after treatment with non-steroidal antiinflammatory drugs. Eur J Pediatr. 2004 163 148-150. 

Antibiotics, in combination with NSAIDs, ACE inhibitor and contrast media, are responsible for the majority of cases with drug-induced ARF. The antibiotic class most often implicated is the aminoglycosides [4, 5, 8]. Acute renal failure complicating treatment with aminoglycosides occurs in about 10% of therapeutic courses most of these patients receive inappropriate regimens of the drug [7. ... 

Hemoperfusion for acute poisoning—routine treatment in patients Hemoperfusion for aluminium and iron overload— routine treatment in patients Supplement to hemodialysis in end-stage renal failure—routine treatment in patients Artificial liver support hemoperfusion and hybrid systems—experimental Red blood cell substitutes for transfusion—Phase I and Phase 11 clinical trials Blood group antibodies removal (immunosorbents)—clinical trial Hereditary enzyme deficiency—clinical trial Clinical laboratory analysis—clinical application Production of monoclonal antibodies—development... 

Zuin M, Giorgini A, Selmi C, Battezzati PM, Cocchi CA, Crosignani A, Benetti A, Invemizzi P, Podda M. Acute liver and renal failure during treatment with buprenorphine at therapeutic dose. Dig Liver Dis 2009 41(7) e8-10. 

M. Zuin, A. Giorgini, C. Selmi, P. M. Battezzati, C. A. Cocchi, A. Crosignani, A. Benetti, P. Invernizzi and M. Podda, Acute liver and renal failure during treatment with buprenorphine at the therapeutic dose. Dig. Liver Dis., 2009, 41, c8-el0. 

Mannitol (Osmitrol) is used for the promotion of diuresis in the prevention and treatment of the oliguric phase of acute renal failure as well as for the reduction of IOP and the treatment of cerebral edema Urea (Ureaphil) is useful in reducing cerebral edema and in die reduction of IOE Glycerin (Osmoglyn) and isosorbide (Ismotic) are used in the treatment of acute glaucoma and to reduce IOP before and after eye surgery. 

Apply knowledge of the pathophysiology of acute renal failure to the development of a treatment plan. 

Renal dose dopamine is not recommended in the prevention or treatment of acute renal failure. 

The pathophysiology, clinical manifestations, diagnosis, and treatment of acute renal failure and chronic kidney disease (CKD) or end-stage renal disease are discussed in Chaps. 75 and 76, respectively. 

A common cause of renal failure in the elderly is the use of NSAIDs and it occurs more frequently in women. One to five percent of treatment with NSAIDs leads to some kind of renal dysfunction and mostly vasomotor acute renal failure occurs (Bakris and Kern 1989, Griffin et al. 2000, Henry et al. 1997). 

Ischemic acute renal failure (ARF), characterized by a sharp decline of glomerular filtration rate, is a very common complication in hospitalized patients and particularly in patients with multiorgan failure. Although it develops most frequently in multimorbid patients, its occurrence per se increases the risk of death by 10- to 15-fold (Ghertow et al, 1998). This unacceptable situation in both diseases warrants the urgent development of new treatment modalities. 

In patients with severe CHF whose renal function may depend on the activity of the renin-angiotensin-aldosterone system, treatment with ACEIs may be associated with oliguria or progressive azotemia and, rarely, with acute renal failure or death. Impaired renal function decreases lisinopril elimination. The elimination half-life of quinaprilat increases as Ccr decreases. Dosage adjustment may be necessary for quinapril, benazepril, ramipril, and lisinopril. Impaired renal function decreases... 

Extrapyramidal symptoms (EPS) Dystonic reactions develop primarily with the use of traditional antipsychotics. EPS has occurred during the administration of haloperidol and pimozide frequently, often during the first few days of treatment. Neuroleptic malignant syndrome (NMS) A potentially fatal symptom complex sometimes referred to as NMS has been reported in association with administration of antipsychotic drugs. Clinical manifestations of NMS are hyperpyrexia, muscle rigidity, altered mental status, and evidence of autonomic instability (irregular pulse or blood pressure, tachycardia, diaphoresis, cardiac dysrhythmia). Additional signs may include elevated creatine phosphokinase, rhabdomyolysis, and acute renal failure. 

Renal toxicity Acute renal failure has been observed in severely ill patients undergoing treatment with voriconazole. 

---