Li et al identified risk factors associated with development of acute renal failure in a patient with severe acute pancreatitis. These can help to identify a patient who may benefit from more aggressive management. The authors are from Hunan Provincial People's Hospital, Xiangya Hospital, and Central South University in Changsha, China.
Patient selection: severe acute pancreatitis
Factors associated with development of acute renal failure:
(1) history of pre-existing renal disease
(2) hypoxemia
(3) abdominal compartment syndrome
Steps to prevent acute renal failure:
(1) decompress abdomen to avoid elevated intra-abdominal pressuers
(2) maintain adequate perfusion of the kidneys
(3) provide adequate arterial oxygenation
(4) treat any underyling kidney disease
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