Prevention and Treatment of Acute Renal Failure Timing in the Use of Dialysis

  • V. Gašparović
  • M. Gjurašin
  • I. Jelić
Conference paper


The clinical syndrome of acute renal failure (ARF) usually occurs as a complication of some other event, while disturbances of the fluid and electrolyte metabolism, acid-base balance and azotaemia additionally complicate the etiologic events [1]. ARF can be induced by different etiologic moments, among which polytrauma, inflammatory processes and severe intoxication predominate [2] . The differential diagnosis of ARF includes prerenal azotaemia, intrinsic acute renale failure and postrenal obstruction. Prerenal azotaemia is the most common (about 70% of ARF cases). Intrinsic renal damage is responsible for 25% and postrenal azotaemia for less than 5% of all azotaemia [3]. The differentiation of prerenal, intrinsic and postrenal azotaemia is important because of the different modes of therapy. In this paper we will discuss the possibilities of prevention of acute renal failure, management strategies, the indications and correct timing for haemodialysis. Very often intrinsic ARF is a part of multiple organ failure. Sometimes, however, it is an independent event. In the study, attempts were made also to determine the extent to which ARF develops merely as a part of the syndrome of multiple organ failure, and how often it is an independent manifestation.


Acute Renal Failure Atrial Natriuretic Peptide Multiple Organ Failure Unilateral Ureteral Obstruction Circulation Failure 
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  1. 1.
    Schrier RW (1982) Acute renal failure. JAMA 247:2518–2524PubMedCrossRefGoogle Scholar
  2. 2.
    Gjurašin M, Duraković Z, Gašparović V et al (1988) Liječenje akutnog zatajenja bubrega nekada i danas. Liječ Vjesn 110:3447–3453Google Scholar
  3. 3.
    Brady HR, Singe GG (1995) Acute renal failure. Lancet 346:1533–1540PubMedCrossRefGoogle Scholar
  4. 4.
    Wagner K, Albrecht S, Neumayer HH (1987) Prevention of post-transplant acute tubular necrosis by the calcium antagonist diltiazem: a prospective randomised study. Am J Nephrol 7:287–291PubMedCrossRefGoogle Scholar
  5. 5.
    Gubern JM, Sancho JJ, Simo J et al (1988) A randomized trial on the effect of mannitol on postoperative renal function in patients with obstructive jaundrice. Surgery 1103:82–86Google Scholar
  6. 6.
    Stone AM, Stahl WM (1971) Effects of ethacrynic acid and furosemide on renal function in hypovolaemia. Ann Surg 174:1–11PubMedCrossRefGoogle Scholar
  7. 7.
    Maiorca R, Cancarini GC, Yubani R et al (1996) Differing dialysis treatment strategies and outcome. Nephrol Dial Transplant 11(s2):134–139PubMedCrossRefGoogle Scholar
  8. 8.
    Hakim RM (1993) Clinical implications of haemodialysis membrane biocompatibility. Kidney Int 44:484–494PubMedCrossRefGoogle Scholar
  9. 9.
    Schiffl H, Lan SM, Konig A et al (1994) Biocompatible membranes in acute renal failure: prospective case-controlled study. Lancet 344:570–572PubMedCrossRefGoogle Scholar
  10. 10.
    Kurtal H, von Herrath D, Schaefer K (1995) Is the choice of membrane important for patients with acute renal failure requiring haemodialysis? Artif Org 19:391–394CrossRefGoogle Scholar
  11. 11.
    CSS (1991) Statistica. Vol I, Quick CCS, Statisticasoft, PCGoogle Scholar
  12. 12.
    Hakim RM, Wingard RL, Parker RA (1994) Effect of the dialysis membrane in the treatment of patients with acute renal failure. N Engl J Med 17:1338–1341CrossRefGoogle Scholar
  13. 13.
    Schiffl H, Sitter T, Lang S (1995) Haemodialysis in acute renal failure: which type of dialysis membrane. Yearbook of Intensive Care Medicine 757–763Google Scholar
  14. 14.
    Conger JD (1975) A controlled evaluation of prophylacticdialysis in posttraumatic acute renal failure. Semin Nephrol 15:1056–1063 15. Gašparović V, Radonić R, Gjurašin M et al (1995) Acute renal failure in the war in Croatia. Nephrol Dialys Transpl 10:1261Google Scholar
  15. 14.
    Gašparović V, Radonić R, Gjurašin M et al (1995) Acute renal failure in the war in Croatia. Nephrol Dialys Transpl 10:12–61Google Scholar
  16. 16.
    Gašparovič V, Ileković K, GjuraŠin M et al (1996) Acute renal failure — a part of the syndrome of multiple organ failure or an independent event? Neurol Croat 45(S1):67–71Google Scholar

Copyright information

© Springer-Verlag Italia 1997

Authors and Affiliations

  • V. Gašparović
  • M. Gjurašin
  • I. Jelić

There are no affiliations available

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