[Management of acute renal failure in intensive care patients]

Crucial for the management of acute renal failure is the differentiation in a prerenal, renal and postrenal form. Prerenal acute renal failure, i.e., hypovolemia, and postrenal acute renal failure, i.e., urinary obstruction, can be treated specifically, and generally, these forms of acute renal failure resolve quickly. By contrast, for intrinsic acute renal failure with acute tubular necrosis, there is no specific therapy and supportive care is necessary until renal function resumes. Prevention of intrinsic acute renal failure is important, i.e., avoidance of nephrotoxic substances, maintenance of adequate hydration and perfusion, cure of septic foci. However, in intensive care patients the development of acute renal failure often cannot be prevented. With the incidence of acute renal failure, the prognosis of intensive care patients deteriorates significantly. Temporary extracorporeal detoxification is often necessary, until eventually, there is a restitution of renal function. The prognosis of acute renal failure in intensive care patients is poor, if there is preexisting renal disease or the cause of the acute renal failure cannot be eliminated.