Insuficienţa renală acută în practica medicală şi chirurgicală (State of the art lecture)

Abstract

Acute renal failure (ARF) is a rapid alteration of the renal function that results in hydroelectrolitical, acido-basic and nitrogen disturbances. Only 8% of the ARF with isolated kidney impairment have a lethal outcome, and 65-70% in the presence of polyorganic comorbidity. Many factors contribute to the ARF development, determining hemodynamic, interstitial and obstructive forms. Critic decrease in the glomerular ultrafiltration due to cortical vasoconstriction, retrodifusion of the glomerular filtrate and tubular obstruction are responsible for ARF evolution. Diuresis stimulation after hemodynamic and hydroelectrolitical rehabilitation usually results in the urine output increasing, in other cases extracorporeal epuration methods as hemodialysis, hemocarboperfusion or other will be needed. 474 patients with ARF have been treated in the Hemodialysis and Kidney Transplantation Department Clinical Republican Hospital during the period 1979-2005, having 25,7% lethality.