Acute Renal Failure

The medical consultant may be asked to evaluate a patient with renal insufficiency, either for acute renal failure (ARF) or for issues related to chronic renal insufficiency (CRI). Various etiologies for ARF exist in the hospitalized patient, with the major causes being acute tubular necrosis (ATN) and prerenal disease (due to sepsis, congestive heart failure, or true volume depletion).1-3 For patients with CRI, management issues include prevention of contrast-induced nephropathy 4,5, control of blood pressure6, treatment of anemia6, and addressing problems with hemostasis7. This chapter addresses some of the more important considerations in evaluating patients with renal insufficiency. Another chapter specifically addresses the pre-operative evaluation of a patient with renal insufficiency