Acute renal failure can not be cured

Some patients heard a doctor said, "your disease is acute renal failure", suddenly feel no medicine can be medical, in fact, acute renal failure after timely and active treatment, renal function can be restored to normal. The general principle of treatment is to remove the cause, to maintain water, electrolyte and acid-base balance, reduce symptoms, improve renal function, prevention and treatment of complications. From the clinical manifestations, we know that acute renal failure is divided into three, the same treatment in these three periods also have a focus, especially oliguria. In the treatment of oliguria, oliguria often due to acute pulmonary edema, hyperkalemia, upper gastrointestinal bleeding and concurrent infection leading to death. Therefore, the focus of treatment for the regulation of water, electrolyte and acid-base balance, control of nitrogen retention, the supply of appropriate nutrition, prevention and treatment of complications and treatment of primary disease.

(1) bed rest: all patients with clear diagnosis should be strictly bed rest.

(2) diet: to eat as much as possible to use the gastrointestinal tract to add nutrition, to give light liquid or semi-liquid food-based. Limit moisture, sodium and potassium salts, as appropriate. Early to limit the protein, and then step by step to add part of the heat, too fast, too much to add food can not be absorbed, easily lead to diarrhea.

(3) to maintain water balance: oliguria patients should be strictly calculated 24 hours into the water.

(4) treatment of hyperkalemia: the most effective method for hemodialysis or peritoneal dialysis. If there is severe hyperkalemia or high catabolic status, hemodialysis is appropriate. Hyperkalemia is a clinical emergency situation, in the preparation of dialysis before treatment should be a corresponding emergency treatment. (5) the treatment of hyponatremia: hyponatremia is generally dilute, the total amount of sodium in the body did not decrease, so only in the <120mmol / L or although 120-130mmol / L but low sodium symptoms when the supply.

(5) hypocalcemia and hyperphosphatemia: calcium can be used 10% calcium gluconate, hyperphosphatemia should be limited to phosphorus-containing food, and can take aluminum hydroxide or calcium phosphate.

(6) to correct metabolic acidosis: non-high catabolic oliguria patients, add enough calories, reduce the body tissue decomposition, the general metabolic acidosis is not serious. But the high metabolic metabolic metabolic acidosis early, serious, can increase the hyperkalemia, should be timely treatment. Serious metabolic acidosis should be done as soon as possible hemodialysis more secure.

(7) the application of furosemide and mannitol: mannitol as a permeable diuretics can be applied to crush injury cases of forced diuretic, but has been diagnosed as oliguria (anuria) patients to stop using mannitol, so as to avoid blood volume Many, induced heart failure, pulmonary edema.

(8) anti-infective treatment: to carry out early preventive dialysis, oliguria patients died of acute pulmonary edema and hyperkalemia were significantly reduced, and infection has become the main cause of death in oliguria. Common for the blood, lungs, urinary tract, bile duct and other parts of the infection, according to bacterial culture and drug sensitivity test rational selection of renal non-toxic effect of antibiotic treatment.

(9) nutritional support therapy: acute renal failure patients, especially sepsis, severe trauma associated with high metabolic status, lack of calorie intake every day, easily lead to rapid progression of azotemia. Nutritional support can provide enough calories to reduce protein breakdown in the body, thereby slowing the rate of elevated blood nitrogen, increasing body resistance, reducing oligodial mortality, and possibly reducing the number of dialysis.

(10) hemodialysis or peritoneal dialysis: early preventive hemodialysis or peritoneal dialysis can reduce acute renal failure infection, bleeding, hyperkalemia, fluid retention and coma and other life-threatening complications. What is preventive dialysis? Refers to the implementation of complications before the implementation of dialysis, which can quickly remove excess metabolites in the body, maintaining water, electrolyte and acid-base balance, which is conducive to maintaining cell physiological function and the body environment stability, treatment and Prevention of various complications of primary disease.

(12) polyuria treatment: when the patient's urine began to increase, gradually into the polyuria period, must not be considered behind the risk and be taken lightly. The threat of life at the beginning of this period still exists. The focus is still on maintaining water, electrolyte and acid-base balance, controlling azotemia, treating primary disease and preventing various complications. For those who can not get up, especially in the prevention and treatment of pulmonary infection and urinary tract infection. 3. Recovery period of treatment generally do not need special treatment, regular follow-up renal function, to avoid the use of drugs that damage the kidney. The prognosis of the disease often with the original nature of the disease, age, the original chronic disease, the severity of renal damage, early diagnosis and early treatment and dialysis or not, with or without multiple organ failure and complications and other factors. In short, patients with acute renal failure should be carefully treated according to the above principles, as far as possible to prevent the development of irreversible renal failure.

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