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In most people, acute tubular necrosis is reversible. The goal of treatment is to prevent life-threatening complications of acute renal failure during the time the lesion is present.
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Treatment focuses on preventing the excess accumulation of fluids and wastes while allowing the kidneys to heal. Observation for deterioration of kidney function should be ongoing.
Fluid intake may be restricted to a volume equal to the volume of urine produced.
The intake of substances that are normally excreted by the kidney may be restricted to minimize their buildup in the body. This may include a diet high in carbohydrates, low in protein, reduced sodium, and reduced potassium.
The underlying cause must be identified and treated.
Diuretics (water pills) may be used to increase fluid excretion from the kidney. Medications may be given to control potassium levels in the bloodstream.
Dialysis may be used to remove excess waste and fluids. This often makes the person feel better, and may make the kidney failure easier to control. Dialysis may not be necessary for all people, but is frequently lifesaving, particularly if serum potassium is dangerously high.
Decreased mental status, pericarditis, increased potassium levels, total lack of urine production, fluid overload, and uncontrolled accumulation of nitrogen waste products are common indications for dialysis.
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