Prevention of postoperative acute renal failure.

摘要: Postoperative acute renal failure (PO-ARF) is a serious complication resulting in prolonged stay and high mortality. Patients may be at risk for this problem because of an underlying medical illness, nature surgery, nephrotoxin exposure, or combinations these factors. An increase the intra abdominal pressure above 20-mm Hg associated with incidence PO-ARF. Based on many clinical studies high-risk surgical patients undergoing transplantation, only proven management strategies prevention PO-ARF are adequate volume expansion avoidance hypovolaemia. Drugs known to nephrotoxic should avoided used caution. Three main pharmacological agents namely mannitol, frusemide dopamine have been extensively tried Mannitol has value presence attenuating dysfunction transplant patients. Frusemide converts oliguric non-oliguric failure. The bulk data, including that from prospective indicate diuretic. Fenoldopam, analogue, shown early promise reports. Calcium channel blockers not improve outcome transplantation help contrast-induced nephropathy. Atrial natriuretic peptide benefit established its role assessed.