Insuffisance rénale aiguë obstructive : le point de vue du réanimateur

Obstructive acute renal failure in adults is a frequent situation. Irrespective of the cause, the urinary tract obstruction can acutely oppose glomerular filtration and induce tubulo-interstitial injury, while prolonged obstruction may eventually produce irreversible renal lesions. Importantly, depending on the completeness of the obstruction, renal failure may rapidly lead to life-threatening complications, including hyperkalemia and pulmonary edema. Therefore, prompt and adequate coordination between medical and urological management is necessary. In this article we concisely review evidence regarding the pathophysiology of obstructive nephropathy and the medical management of complications associated with obstructive acute renal failure.