Acute renal failure in intensive care unit

Abstract

In hospitalized patients, acute renal failure(ARF) has an incidence from 2 % to 5%, mostly due to: septic shock, hypovolemia, aminoglycoside use, cardiac failure and radiocontrast media. Some of these patients are in the intensive care unit (ICU) and show high rates of mortality despite the advances of treatment. In this paper, we discuss the most common causes of ARF, emphasizing prevention in the hospitalized patients and the importance of the differencial diagnosis between pre-renal and renal causes of ARF. Among the renal causes, acute tubular necrosis (ATN) has a high incidence provoked by either hypoperfusion and/or exogen and endogen nephrotoxins. Hydro-eletrolytic balance, nutritional assessment and dialysis are the main topics to be considered in the treatment. The dialytic treatment, when required, can be instituted as peritoneal dialysis, hemodialysis and the continuous renal replacement methods of therapy.