Figure 182

Metabolic perturbations in acute renal failure (ARF). In most instances ARF is a complication of sepsis, trauma, or multiple organ failure, so it is difficult to ascribe specific metabolic alterations to ARF. Metabolic derangements will be determined by the acute uremic state plus the underlying disease process or by complications such as severe infections and organ dysfunctions and, last but not least by the type and frequency of renal replacement therapy [1, 2].

Nevertheless, ARF does not affect only water, electrolyte, and acid base metabolism: it induces a global change of the metabolic environment with specific alterations in protein and amino acid, carbohydrate, and lipid metabolism [2].

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