Novel approaches to the treatment of acute renal failure.
Acute renal failure (ARF) occurs frequently in hospitalised patients and is associated with significant morbidity and mortality. Many therapeutic strategies have been undertaken both to prevent acute renal injury and, once ARF occurs, to improve renal function and reduce mortality. Among the available pharmacological options, no specific therapy has been shown to alter the course of ARF. This article reviews the efficacy of several strategies in experimental renal disease and raises the possibility that similar interventions might be available to the clinician in the near future for the prevention and management of ARF. The prospect of these novel strategies, together with the ever-increasing understanding of the complex pathophysiology of ARF, offers the promise of effective and more physiological therapeutic interventions in this new millennium.
Venkataraman
Ramesh
R
Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Scaife Hall, Room 642A, 3550 Terrace Street, Pittsburgh, PA 15261, USA. venkataramanr@ccm.upmc.edu
Kellum
John A
JA
D000111:Acetylcysteine / Q000627:therapeutic use; D058186:Acute Kidney Injury / Q000188:drug therapy* / Q000503:physiopathology; D009320:Atrial Natriuretic Factor / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D018491:Dopamine Agonists / Q000627:therapeutic use; D065128:Endothelin Receptor Antagonists; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006801:Humans; D058915:Purinergic P1 Receptor Antagonists; D012076:Renal Agents / Q000627:therapeutic use*
D002121:Calcium Channel Blockers; D018491:Dopamine Agonists; D065128:Endothelin Receptor Antagonists; D058915:Purinergic P1 Receptor Antagonists; D012076:Renal Agents; D009320:Atrial Natriuretic Factor; D000111:Acetylcysteine