Renal Protective Strategies

The cornerstones of good renal protection are not the administration of various drugs, but good clinical practice ie:


  • Adequate fluid resuscitation (sometimes a difficult concept)

  • Haemodynamic support to maintain both a good renal perfusion pressure and adequate blood flow.  Where necessary this may involve inotrope and/or vasopressor support.  Despite historical anxiety about the use of vasopressor (Noradrenaline), it is not harmful to the kidneys and may in fact increase renal blood flow in animal studies.

  • Avoid nephrotoxic drugs where necessary

  • Treat intercurrent infection

  • Active surveillance for abdominal compartment syndrome, where this is appropriate.

  • Low dose domamine and frusemide have been used to promote urine output, but have not been found to impact on progression to dialysis or mortality.


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Page last reviewed: 13 May 2014