Acute renal failure as a complication in the critically ill animal

Acute renal failure is associated with a high morbidity and mortality in the intensive care animal. The two most common causes are ischemic/reperfusion injury and insult from nephrotoxins. Damage to the renal cells (e.g., endothelial, tubular, or mesangial cells) and altered hemodynamics result in reduced glomerular blood flow, tubular backleak, tubular obstruction, and/or decreased glomerular permeability. Recognition of ARF during the initiation stage provides the optimal chance for recovery. Adequate circulatory blood volume and systemic blood pressure must be established prior to pharmacologic intervention. Once ARF is in the maintenance phase, metabolic consequences of uremia must be managed.