Clostridium difficile causing acute renal failure: Case presentation and review

Table 1 Treatment of acute renal failure[7].

Reverse underlying causes

Return intravascular volume and mean arterial pressure to normal

Correct electrolyte imbalances

Treat hyperkalaemia and acidosis with inhaled beta-agonists, insulin/glucose, sodium bicarbonate, binding resins (sodium polystyrene sulfonate)

Discontinue or avoid nephrotoxins

Adjust doses of medications that are eliminated by the kidney or by dialysis

Initiate renal replacement therapy in case of volume overload, hyperkalaemia, metabolic acidosis refractory to medical treatment

Obtain nephrologic consultation as soon as possible

Table 2 Treatment of infections with toxigenic C. difficile[5].

Discontinuation of offending antibiotic

Correction of fluid loss and electrolyte imbalance

Antimicrobial agents if symptoms are severe or persistent

Oral agents (preferred)

Metronidazole: 250 mg, four times daily to 500 mg 3 times daily for 7–14 d

Vancomycin: 125 mg, four times daily, 7–14 d

Parenteral agent

Metronidazole: 500 mg, given intravenously every 6 h