Acute renal failure (ARF) is a clinical entity characterized by an abrupt (hours to days) decline in glomerular filtration rate, resulting in the retention of nitrogenous waste products and pertubation of water, electrolyte, and acid-base balance. It is typically associated with daily increments in serum urea and creatinine levels greater than 3.57 mmol/l and 44.2 mol/l respectively.
ARF is frequently encountered, occurring in approximately 5 per cent of all hospital patients and up to 30 per cent of intensive care unit admissions. Oliguria (urine output < 400 ml/day) is observed in 50 per cent of cases of ARF, with an associated mortality of 50 to 80 per cent. Non-oliguric ARF has a better prognosis with a mortality of 15 to 40 per cent.
As illustrated in Table.!, a significant decline in glomerular filtration rate (of more than 50 per cent) may derive from prerenal azotemia, acute intrinsic renal failure, or obstructive uropathy (postrenal azotemia).
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