Treatment for Acute Kidney Failure Caused by Sepsis

When someone has sepsis or septic shock, the doctors work to treat the sepsis, the infection that caused the sepsis, and the damage that the sepsis has done, such as the kidney failure.

If the kidneys are not working efficiently enough to filter toxins and allow urine to flow, an artificial way of filtering the kidneys, dialysis, will be needed. Dialysis is not a cure but it gives the doctors a way to clean the blood while they try to get everything else under control. There are two types of dialysis, hemodialysis and peritoneal dialysis. Peritoneal dialysis is generally used for people with chronic kidney failure, but it can be used for acute kidney failure where hemodialysis isn’t possible, in areas with limited resources. For example, peritoneal dialysis has been used in Africa, for patients who have malaria-associated acute kidney injury.

With hemodialysis, a machine, called a hemodializer, is the artificial kidney. A catheter (tube) is inserted into the patient’s vein and the other end of the catheter leads into the hemodializer. When the process starts, blood flows a few ounces at a time, from the patient’s body to the machine, where it is filtered and then sent back through the catheter to the body.

How often dialysis is needed and how long each procedure takes depends on how much kidney function still exists, how small or big the patient is, and how much toxins have accumulated in the blood since the previous treatment. Dialysis can be intermittent (for three or four hours every or every other day) or it can be continuous, but at a slower rate.

In acute kidney failure, dialysis is usually considered a temporary measure as the doctors work to fix the problem that caused the kidneys to stop working effectively. If the kidneys begin to work properly again, even if not at 100 percent, dialysis usually is no longer needed.

Some people do need to continue receiving dialysis treatments if the kidney damage is too severe and is permanent. Since dialysis is not a cure, if they qualify, they may be candidates for a kidney transplant.

 

Post-sepsis kidney function

Some sepsis survivors continue to have problems with their kidneys, despite recovering from the sepsis itself. If there is lasting kidney damage, patients will be monitored for their kidney function, which would mean having to have regular check-ups and blood tests.