treatment of prerenal failure

Last reviewed 01/2018

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Acute prerenal failure caused by prerenal factors is managed as the following:

  • volume replacement:
    • best given by mouth as water
    • fluid losses are assessed and replaced
    • supplements of potassium or sodium are given if dietary intake and serum plasma levels indicate need
    • sick patients may require intravenous hydration

  • monitoring of fluid and electrolyte requirements:
    • central venous pressure should be monitored
    • in ITU a Swan-Ganz catheter may be used determine the pulmonary wedge pressure

  • if pre-renal failure is suspected but there is no response to fluid replacement then administer:

    • loop diuretic e.g. furosemide:
      • contraindicated if aminoglycosides have been given
      • give as i.v. infusion

    • renal dose dopamine:
      • administered via a central line infusion