BMJ  2006;333:786-790 (14 October), doi:10.1136/bmj.38975.657639.AE

Clinical review

Acute renal failure

¹ Guy's and St Thomas' NHS Foundation Trust, Guy's Hospital, London SE1 9RT

The first 150 words of the full text of this article appear below.

Introduction

Acute renal failure is characterised by a rapid fall in glomerular filtration rate, clinically manifest as an abrupt and sustained rise in urea and creatinine. Life threatening consequences include volume overload, hyperkalaemia, and metabolic acidosis. Acute renal failure is both common and costly and carries a high morbidity and mortality. As it is often preventable, identification of patients at risk and institution of appropriate preventive measures are crucial. In incipient or established acute renal failure rapid recognition and treatment may prevent irreversible loss of nephrons.

In most cases of acute renal failure initial management is by non-specialist clinicians, often comparatively junior ones. All clinicians should therefore be able to recognise the symptoms and signs of acute renal failure, request and interpret initial investigations, initiate appropriate treatment, and know when, and how urgently, to consult a more experienced colleague or specialist. This review highlights the common causes of acute renal failure, . . . [Full text of this article]

Who gets acute renal failure?

What causes acute renal failure?

Pre-renal failure (box 1)
"Intrinsic" renal failure (box 2)
Post-renal failure (box 3)

Can acute renal failure be prevented?

How do I assess a patient with acute renal failure?

Is this acute or chronic renal failure?
Has obstruction been excluded?
Is the patient euvolaemic?
Is there evidence of renal parenchymal disease (other than acute tubular necrosis)?
Has a major vascular occlusion occurred?

What investigations are most useful in acute renal failure?

How do I manage a patient with acute renal failure?

When do I need to speak to a nephrologist?

Conclusions

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Relevant Articles

Acute renal failure: Estimated glomerular filtration rate should be entered on drug charts

Gavin Dreyer
BMJ 2006 333: 917. [Extract] [Full Text]

Acute renal failure: Beware development of abdominal compartment syndrome

Jeremy S Bewley
BMJ 2006 333: 917-918. [Extract] [Full Text]

Assessing and managing acute renal failure
BMJ 2006 333: 0. [Full Text]

Meta-analysis of frusemide to prevent or treat acute renal failure

Kwok M Ho and David J Sheridan
BMJ 2006 333: 420. [Abstract] [Full Text] [PDF]

Lesson of the week: Cholesterol emboli syndrome

Peter J Dupont, Liz Lightstone, Elaine J Clutterbuck, Gillian Gaskin, Charles D Pusey, Terry Cook, and Anthony N Warrens
BMJ 2000 321: 1065-1067. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

• Abuelo, J. G. (2007). Normotensive Ischemic Acute Renal Failure. NEJM 357: 797-805 [Full text]  
• Dreyer, G. (2006). Acute renal failure: estimated glomerular filtration rate should be entered on drug charts.. BMJ 333: 917-917 [Full text]  
• Bewley, J. S (2006). Acute renal failure: beware development of abdominal compartment syndrome.. BMJ 333: 917-918 [Full text]  

Rapid Responses:

Read all Rapid Responses

Acute Renal Failure

Sameer Chadha, et al.
bmj.com, 14 Oct 2006 [Full text]

How to measure renal function in clinical practice

Adie Viljoen, et al.
bmj.com, 16 Oct 2006 [Full text]

eGFR should be clearly documented on drug charts

Gavin Dreyer
bmj.com, 17 Oct 2006 [Full text]

Acute Renal Failure managment

Prasanna Rao-Balakrishna
bmj.com, 17 Oct 2006 [Full text]

Intensive care management of acute renal failure

Jeremy S Bewley
bmj.com, 18 Oct 2006 [Full text]

Acute renal failure - a classification based on function

Sharmistha Saha, et al.
bmj.com, 23 Oct 2006 [Full text]

Definitions for Renal Failure

Ian D Nesbitt, et al.
bmj.com, 23 Oct 2006 [Full text]

Which specialist?

T John Trinder
bmj.com, 26 Oct 2006 [Full text]