Acute renal failure: a practical update.

Acute renal failure (ARF) affects almost all medical specialties. Its occurrence seems to be increasing in hospitalized patients. A structured approach to the evaluation and management of ARF would facilitate rapid diagnosis and treatment in most patients. Appreciation for the multiple drugs that affect renal function is especially important. Exclusion of urinary outflow obstruction and administration of therapies that improve renal perfusion should be given top priority with respect to managing ARF. Dialytic intervention for ARF is required when otherwise irreversible pathophysiologic derangements of electrolyte homeostasis, fluid balance, and uremic solute control are imminent. This article provides a brief review and update on the clinical evaluation and management of ARF.