The goal of treatment is to identify and treat any reversible causes of the kidney failure (e.g., use of kidney-toxic medications, obstructive uropathy, volume depletion). Treatment also focuses on preventing excess accumulation of fluids and wastes, while allowing the kidneys to heal and gradually resume their normal function. Hospitalization is required for treatment and monitoring.
Your fluid intake may be severely restricted to an amount equal to the volume of urine you produce. You may be given specific dietary modifications to reduce build-up of toxins normally handled by the kidneys, including a diet plan high in carbohydrates and low in protein, salt, and potassium.
Antibiotics may be used to treat or prevent infection. Diuretics may be used to remove fluid from the kidney. A major priority in treatment is to control dangerous hyperkalemia (increased blood potassium levels). A variety of different medications may be used, including IV (intravenous) calcium, glucose/insulin, and oral or rectal administration of potassium exchange resin (Kayexalate).
Dialysis may be used to remove excess waste and fluids. This often makes the person feel better and may make the kidney failure easier to control. Dialysis may not be necessary for all people, but is frequently lifesaving, particularly if serum potassium is dangerously high. Common symptoms that require the use of dialysis include decreased mental status, pericarditis, increased potassium levels, total lack of urine production, fluid overload, and uncontrolled accumulation of nitrogen waste products (serum creatinine > 10 mg/dl and BUN > 120 mg/dl).
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