Acute Renal Failure
Acute renal failure (ARF) is a common problem in the ICU. Even modest degrees of ARF not resulting in dialysis treatment increase the risk of death approximately fivefold.1 The mortality of patients who require dialysis has remained in excess of 50% despite improvements in renal replacement therapy and aggressive supportive care. It is therefore essential that all efforts be made to avoid this complication, i.e., aggressive (early) fluid resuscitation and avoidance of potentially nephrotoxic drugs (especially aminoglycosides and contrast media). The therapeutic intervention of choice in patients with oliguria is fluid resuscitation and not furosemide/Lasix™ (see Chapter 8).
KeywordsDopamine Cyclosporine Myeloma Vancomycin Tacrolimus
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