Can acute renal failure be fatal?

Yes. ARF is a serious condition. In hospital admitted patients the mortality is as high as 50%.

How is ARF detected?

ARF is detected when there is an abrupt decrease in the urine output and there is a rise in the creatinine. The symptoms will depend on the underlying condition that caused it. For E.g. in excess vomiting the patient will present with signs and symptoms of volume depletion.

Is there any treatment for acute renal failure?

The treatment of ARF is directed at the underlying cause. In volume depleted patients the blood pressure should be raised by giving fluids. blood etc. The offending drug has to be identified and stopped. In some cases dialysis may have to be started which usually is temporary.

Does a patient with CRF require any vitamin supplements?

The diet should be supplemented with vitamins B, vitamins C and also folic acid. Vitamin D should be reserved for those for treatment with severe Renal Osteodystrophy. It is a condition which result from low calcium in the blood which stimulates secretion of a hormone called as PTH which acts on the bone. These patient will usually have low calcium and a high phosphorous. These patients should be treated with calcium supplements.

Is there is any restriction on intake of potassium?

The patients should be watchful about their intake of potassium. High potassium containing foods like bananas, tomatoes, oranges, fruit juices should be avoided.

How much water am I permitted if I have chronic renal failure?

Intake of water should be based on the individual requirements as assessed by the physician. It is important to note that the patients with chronic renal failure are sensitive both to volume expansion and contraction and therefore should have regular follow up with the physicians. Generally mild fluid restriction is advised about 1–1.5L/day.

How important is it to control the blood pressure in CRF?

The treatment of hyper tension is extremely important as studies are shown that the control of hypertension slows the process of chronic renal failure.

What is the cause of anemia in CRF?

It is related to the deficient Erythropoeitin production. Erythropietin stimulates the bone marrow to produce red blood cells.

Is there any treatment for the anemia?

Erythropoeitin injections can be used to treat the anemia. It is important to evaluate the iron status prior to starting these injections.

What are the different treatments available for the treatment of end stage renal failure?

The following methods are available

• Hemodialysis.
• Peritoneal dialysis.
• Kidney transplant.

When is dialysis initiated in a patient with CRF?

Current recommendations are to initiate dialysis early i.e. when the kidney function falls below 25% of normal as measured by the creatinine clearance. It is not considered prudent to wait till symptoms of advanced renal failure have set in such as nausea, vomiting, or fluid accumulation in the lungs.