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Azotemia prerrenal - Treatment

Nombres alternativos

Disminución de la perfusión renal; Uremia

Tratamiento:

El principal objetivo del tratamiento es corregir rápidamente la causa antes de que se produzca daño al riñón. Las personas con frecuencia necesitan permanecer en un hospital y pueden requerir tratamiento en una unidad de cuidados intensivos. El tratamiento puede abarcar hemodiálisis o diálisis dentro del cuerpo (diálisis peritoneal).

Los líquidos intravenosos, incluso sangre o hemoderivados, se pueden utilizar para incrementar el volumen sanguíneo. Después de que se haya restablecido dicho volumen, se pueden emplear medicamentos para incrementar la presión arterial y el gasto cardíaco. Estos medicamentos pueden abarcar dopamina, dobutamina y otros medicamentos cardíacos. Se debe igualmente diagnosticar y tratar la disminución en el volumen sanguíneo o en la presión arterial.

Si la persona tiene otros síntomas de insuficiencia renal aguda, el tratamiento debe incluir medicamentos, cambios en la dieta o diálisis.

Expectativas (pronóstico):

Es posible neutralizar la azotemia prerrenal si se puede encontrar y corregir la causa en cuestión de 24 horas. Sin embargo, si la causa no se corrige rápidamente, se puede producir daño al riñón (necrosis tubular aguda).

Complicaciones:

  • Insuficiencia renal aguda
  • Necrosis tubular aguda (muerte del tejido)

Situaciones que requieren asistencia médica:

Se debe acudir al servicio de urgencias o llamar al número local de emergencia (como el 911 en los Estados Unidos) en caso de tener síntomas de azotemia prerrenal.

  • Reviewed last on: 8/12/2009
  • Parul Patel, MD, Private Practice specializing in Nephrology and Kidney and Pancreas Transplantation, affiliated with California Pacific Medical Center, Department of Transplantation, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

Referencias

Goldman L, Ausiello D, eds. Goldman: Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 121.
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