The Japanese Journal of Clinical Dialysis Vol.14 No.2(7)

Theme Recent Advances in Acute Renal Failure: pathogenesis and treatment
Title Treatments for nutrition and metabolism, infection, DIC, hemorrhage and cardiovascular diseases in patients with ARF
Publish Date 1998/02
Author Izumi Yamaji Division of Nephrology and Hypertension, Department of Internal Medicine, Asahikawa Red Cross Hospital
Author Atsushi Wada Division of Nephrology and Hypertension, Department of Internal Medicine, Asahikawa Red Cross Hospital
Author Toshiya Ishiguro Division of Nephrology and Hypertension, Department of Internal Medicine, Asahikawa Red Cross Hospital
[ Summary ] Treatments for nutrition and metabolism, infection, DIC, hemorrhage and cardiovascular diseases in patients with ARF are very important for the recovery of renal function and to decrease mortality. The amount of protein, which depends on the degree of catabolism, should be provided as both essential and nonessential amino acids and enriched with BCAA. Energy should be administered as dextrose mainly depending on metabolic demands. Infections in patients with ARF might become severe because of immunological dysfunction. Particularly, the mortality rate in patients with pulmonary infection is high. DIC in patients with ARF, might cause a bleeding tendency, and worsening or prolongation of renal dysfunction. Prophylactic administration of H2 blocker and vitamin K to patients with ARF is recommended. In elderly patients with ARF, it is important to control the water-electrolyte balance carefully, because the elderly usually have concomitant cardiovascular diseases.
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