[New prospects in the treatment of acute kidney failure]

In the last 25 years, the mortality of renal failure, far from decreasing, has shown a slight tendency towards increasing, despite continuously more sophisticated and expensive therapeutic measures. As an explanation, the greater frequency of intrahospital renal failures, as past of the systemic inflammatory response syndrome which covers dysfunction of various organs and systems, is brought into this. This relative treatment inefficiency leads to the need of investigating new lines of treatment. After reviewing the conservative treatment of acute renal failure, the main alternatives which exist at present, are reviewed, some of which are in the experimental phase. As prognostically poor renal failure appears in relation to the inflammatory response syndrome, the possibility of eliminating mediators there of by means of continuous hemofiltration systems, is being considered. Despite some positive effects, the majority of authors have not managed to achieve a significant reduction of acute renal failure. The theoretical possibility of improving renal function by administration of certain amino acids (Arginine and Glycine), is not confirmed in practice, possibly due to the incidence of oxidative stress. This stress may be a determining factor in the evolution of renal failure, as it induces many risk factors in these patients. However, carefully, the bases for the anti-oxidant therapy are being established. Finally, the treatment with hormones and growth factors, with the aim of stimulating the rapid regeneration of the renal tubule, represents a very attractive therapeutic alternative, though still in the experimental phase.