Treatment of prerenal failure

Seek expert advice.

Acute prerenal failure caused by prerenal factors is managed as the following:

• volume replacement:
  • best given by mouth as water
  • fluid losses are assessed and replaced
  • supplements of potassium or sodium are given if dietary intake and serum plasma levels indicate need
  • sick patients may require intravenous hydration
    
    
• monitoring of fluid and electrolyte requirements:
  • central venous pressure should be monitored
  • in ITU a Swan-Ganz catheter may be used determine the pulmonary wedge pressure
    
    
• if pre-renal failure is suspected but there is no response to fluid replacement then administer:
  
  
• loop diuretic e.g. furosemide:
  • contraindicated if aminoglycosides have been given
  • give as i.v. infusion
    
    
• renal dose dopamine:
  • administered via a central line infusion