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Acute renal failure in bone marrow transplantation
C R King1, N Hoffart, M E Murray
1University of Rochester School of Nursing, NY.
Oncology Nursing Forum
|October 1, 1992
Summary
Acute renal failure (ARF) is a significant risk for bone marrow transplant (BMT) patients, often caused by acute tubular necrosis. Early nursing interventions are crucial for preventing ARF and managing its complications in BMT clients.
Area of Science:
- Nephrology
- Hematology
- Transplantation Medicine
Background:
- Acute renal failure (ARF) is a critical complication following bone marrow transplantation (BMT).
- Intrarenal damage, particularly acute tubular necrosis (ATN), is the predominant cause of ARF in BMT recipients.
- Risk factors include renal ischemia, nephrotoxic agents, and the release of free hemoglobin and myoglobin.
Observation:
- Nurses are pivotal in preventing ARF by identifying at-risk BMT clients.
- Early diagnosis of renal impairment relies on vigilant assessment of fluid status, electrolytes, and daily weights.
- Comprehensive nursing management is essential for hospitalized BMT patients.
Findings:
- ATN, resulting from ischemia or nephrotoxins, is the primary driver of ARF in BMT patients.
- Nursing care focuses on ARF prevention through risk identification and early detection.
- Effective management strategies include preventing drug-induced nephrotoxicity and maintaining homeostasis.
Implications:
- Proactive nursing care can significantly reduce the incidence and severity of ARF post-BMT.
- Early recognition and intervention by nurses improve outcomes for BMT clients experiencing renal impairment.
- Optimizing fluid balance, electrolyte levels, and infection control are key nursing responsibilities in managing ARF.