Acute Renal Failure: Other Treatment

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Other Treatment

Dialysis

When acute renal failure develops, you may need dialysis. Dialysis is a mechanical process that performs the work of healthy kidneys by:

• Clearing wastes, such as urea, from the blood.
• Restoring the proper balance of certain electrolytes in the blood.
• Getting rid of extra fluid from the body.

Before you start dialysis, your doctor will need to create a dialysis access. The access is the site where the dialysis needles can be inserted to send the blood to and from the dialysis machine. For example, you might have a small tube (catheter) placed in a vein in your arm, leg, chest, or neck. The type of access will depend on the type of dialysis you have.

Two types of dialysis may be used to treat acute renal failure:

• Hemodialysis uses a mechanical membrane (dialyzer) to directly filter wastes and remove extra fluid from the blood. It is the most common treatment for acute renal failure. Hemodialysis is typically done on a daily basis for the best results, especially when a person is critically ill.^{5 6}
• Peritoneal dialysis uses the lining of the abdominal cavity and a salt solution (dialysate solution) to remove wastes and extra fluid from the body. Peritoneal dialysis is used much less frequently than hemodialysis for the management of acute renal failure.

In order to measure how well dialysis is working, you will have blood samples drawn before and after dialysis. These will be tested to measure the levels of urea (blood urea nitrogen (BUN)) in your blood. By measuring BUN before and after a dialysis treatment, your doctor can learn how well dialysis has removed wastes from your bloodstream.

After severe acute renal failure develops, dialysis is the only way—other than receiving a kidney transplant—to sustain life.

Treatment for blockages

About 5% of acute renal failure cases are caused by a blockage in the urinary tract that causes waste to build up in the kidneys .¹ This is called postrenal acute renal failure. Treatment may be done to remove or bypass the blockage. If a kidney stone is blocking the urinary tract, your doctor can remove or destroy it. The most commonly used medical procedure for kidney stones is extracorporeal shock wave lithotripsy. This treatment uses sound waves that pass easily through the body but are strong enough to break up a kidney stone.

If your doctor cannot remove the blockage, he or she may reroute the urine flow around the blockage using a catheter or another method. Placing a catheter in the bladder to empty it can quickly relieve symptoms and allow kidney function to return to normal.

Last updated:	June 14, 2007
Author:	Robin Parks, MS
Reviewed By:	E. Gregory Thompson, MD - Internal Medicine, D.C. Mendelssohn, MD, FRCPC - Nephrology
Editors:	Kathleen M. Ariss, MS, Pat Truman, MATC