Conventional Treatment of Acute Renal Failure

Acute renal failure (ARF) is a potentially devastating condition in dogs and cats. Over recent years there has been a move towards better definitions of what is happening in these animals. Increasingly Acute Kidney Injury (AKI) is being used to describe animals that have had evidence of a renal insult without specific signs of failure, such as alterations in concentrating ability or uraemic signs. Not all animals with AKI will go on to develop signs of ARF, but allowing early identification will allow us to stratify risk better and improve therapy aimed at preventing progression.
There are a number of possible causes of acute kidney injury including ischaemic, toxic (e.g. ethylene glycol, lily or drug reactions) and infectious (e.g. pyelonephritis or leptospirosis) causes. Increasingly in cats ureteral obstruction is being recognized as a cause of AKI.
There are a number of factors that impact on management of ARF, but in clinical practice the most important one is whether the animal is producing urine or not. Anuric animals quickly succumb to the cardiovascular effects of hyperkalaemia as potassium excretion is stopped, and although in the short term this can be managed, many of the medical therapies for this have only a short duration of action.  […]