Related Experiment Video

Updated: Aug 24, 2026

A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion
09:02

A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion

Published on: February 2, 2021

What can be done about acute renal failure?

J A Kellum1

  • 1Department of Critical Care Medicine, University of Pittsburgh, School of Medicine, Pittsburgh, Pennsylvania 15261, USA. kellumja@ccm.upmc.edu

Minerva Anestesiologica
|June 3, 2004
PubMed

Insights

Acute renal failure (ARF) affects 5% of hospitalized patients. While drugs have not prevented ARF, N-acetylcysteine (NAC) may reduce contrast-induced ARF, with future treatments focusing on cellular repair.

Area of Science:

  • Nephrology
  • Critical Care Medicine

Background:

  • Acute renal failure (ARF) is a common complication in critically ill patients, affecting up to 5% of those hospitalized.
  • Despite extensive research, pharmacological interventions to prevent ARF or preserve renal function in the critically ill have largely failed, with some even showing detrimental effects.

Purpose of the Study:

  • To review the current understanding of ARF in critically ill patients.
  • To evaluate the efficacy of existing and potential future treatments for ARF.

Main Methods:

  • Review of existing literature on ARF in critically ill patients.
  • Analysis of studies investigating pharmacological interventions and supportive care for ARF.

Main Results:

  • Current drug therapies have not proven effective in preventing ARF onset or progression in critically ill individuals.
  • Emerging evidence suggests N-acetylcysteine (NAC) may decrease ARF incidence related to radiocontrast agents.
  • Advancements in renal replacement therapy (RRT) and novel drugs targeting cellular repair hold promise for improving ARF outcomes.

Conclusions:

  • Pharmacological prevention of ARF in the critically ill remains a significant challenge.
  • N-acetylcysteine (NAC) shows potential in specific ARF contexts, such as contrast-induced nephropathy.
  • Future improvements in ARF management likely depend on enhanced RRT techniques and therapies promoting renal cellular repair.

Related Concept Videos

Acute Kidney Injury V: Interprofessional Care01:20

Acute Kidney Injury V: Interprofessional Care

Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
Dialysis01:27

Dialysis

Renal failure occurs when the kidneys lose their ability to filter waste products from the blood effectively. It can be classified into two types: acute renal failure (ARF) and chronic renal failure (CRF).
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...
Acute Kidney Injury I: Introduction01:22

Acute Kidney Injury I: Introduction

Introduction:Acute Kidney Injury (AKI) describes a swift decrease in kidney function occurring over hours to days, characterized by the kidneys' failure to remove waste products from the bloodstream. This leads to dangerous complications like metabolic acidosis, fluid overload, and electrolyte imbalances, such as hyperkalemia, which can cause life-threatening arrhythmias. AKI is common in both hospital and outpatient settings, often triggered by dehydration, sepsis, or exposure to nephrotoxic...
Acute Kidney Injury VI: Nursing Management01:22

Acute Kidney Injury VI: Nursing Management

Acute Kidney Injury (AKI) results in an inability to maintain fluid, electrolyte, and acid-base balance. Effective nursing management is critical in improving patient outcomes and includes comprehensive patient assessment and targeted interventions.Comprehensive Patient AssessmentA detailed history collection is essential, focusing on any recent infections, nephrotoxic medication use, or chronic conditions such as hypertension and diabetes that may contribute to AKI. During the physical...
Acute Kidney Injury II: Pathophysiology01:29

Acute Kidney Injury II: Pathophysiology

Acute kidney injury (AKI) causes are categorized into three primary categories based on the location of the injury: prerenal, intrarenal (or intrinsic), and postrenal causes. This classification guides clinical management and illustrates how different pathways can impair kidney function.Etiology and Pathophysiology of Acute Kidney Injury1. Prerenal causesEtiology: Prerenal Acute Kidney Injury, the most common type, occurs when reduced blood flow to the kidneys decreases filtration capacity...