Preventing acute renal failure in patients with chronic renal insufficiency: nursing implications.

The kidneys can withstand substantial loss of functional tissue before showing signs of insufficiency that may lead to a life on dialysis. Situations that lead to reduced renal perfusion or exposure to nephrotoxic agents in patients with chronic renal insufficiency can cause acute renal failure and quicken a downhill course to end stage renal disease if preventive measures are not employed. The nurse's role in prevention of acute deterioration of renal function in renal insufficiency includes knowledge of risk factors and nephrotoxins, awareness of fluid volume status, and an appropriate teaching plan.