ACUTE-RENAL-FAILURE .2. DIAGNOSIS, MANAGEMENT, AND PROGNOSIS

When acute renal failure is suspected, prerenal and postrenal influences should be considered and addressed. In cases of established intrinsic renal failure, history of the patient and physical examination findings help to distinguish acute failure from decompensated chronic renal disease. Management of acute renal failure involves fluid therapy, diuretics and/or vasodilators, and management of electrolyte, acid-base, and other systemic complications. Aggressive therapy, including dialysis procedures and nutritional support, may be required in some cases. The prognosis in cases of established acute renal failure is variable and depends on the severity of the renal insult and renal dysfunction, the extent of renal pathology, and individual response to therapy.