Abstract
The first phase of management of acute renal failure, the most important for practicing physicians, is prevention. Exposure to a nephrotoxic substance calls for antidotes and intravenous infusion of an expander of extracellular fluid to combat dehydration or shock. Mannitol also may aid in preventing renal failure. Emergency treatment of hyperkalemia may require the use of sodium chloride, calcium chloride and insulin and peritoneal dialysis. Once acute renal failure is established, it is wise to refer the patient to a special center.