Renal Replacement Therapy In Acute Kidney Injury
Ramy Sameer Abbas Mohammed;
Abstract
Acute kidney injury is characterized by a sudden decrease in kidney function over a period of hours to days, resulting in accumulation of creatinine, urea, and other waste products. It may be associated with retention of sodium and water and the development of metabolic disturbances such as metabolic acidosis and hyperkalemia.
Acute kidney injury has been estimated to account for 1% of hospital admissions and to develop in 5 to 7% of hospitalized patients. In the intensive care unit (ICU), acute kidney injury develops in 5 to 25% of patients. Acute tubular necrosis is the most common cause of hospital-acquired acute kidney injury and usually results from ischemic or nephrotoxic injury to the tubules. In the ICU, acute tubular necrosis is usually multifactorial and may develop from a combination of sepsis, impaired renal perfusion, and nephrotoxic medications.
Renal Replacement Therapy (RRT) is one of the most common clinical procedures in the intensive care unit (ICU). Approximately 4-5% of critically ill patients require RRT during the ICU stay. RRT has long been used as supportive treatment of Acute Kidney Injury (AKI), and has traditionally focused on averting the life threatening derangements associated with kidney failure (i.e. metabolic acidosis, hyperkalemia, uremia, and/or fluid overload), while allowing time for organ recovery. In patients with AKI, RRT is regarded as a type of organ support aimed at achieving metabolic homeostasis and preventing fluid overload and new organ failure. The benefits of RRT must be balanced by potential harm, including risks related to vascular access, infections and anticoagulation.
A number of strategies for RRT may be used. RRT can be applied intermittently (IRRT), e.g. intermittent haemodialysis (IHD) or continuously (CRRT), as in continuous venovenous haemofiltration (CVVHF). IRRT was defined as any form of RRT [haemodialysis (HD), haemofiltration (HF), haemodiafiltration (HDF), isolated ultrafiltration (UF)] prescribed for a period of < 24 hours. CRRT was defined as any form of RRT (HD, HF, HDF, UF) intended to run on a continuous basis until recovery of renal function.
References
Acute kidney injury has been estimated to account for 1% of hospital admissions and to develop in 5 to 7% of hospitalized patients. In the intensive care unit (ICU), acute kidney injury develops in 5 to 25% of patients. Acute tubular necrosis is the most common cause of hospital-acquired acute kidney injury and usually results from ischemic or nephrotoxic injury to the tubules. In the ICU, acute tubular necrosis is usually multifactorial and may develop from a combination of sepsis, impaired renal perfusion, and nephrotoxic medications.
Renal Replacement Therapy (RRT) is one of the most common clinical procedures in the intensive care unit (ICU). Approximately 4-5% of critically ill patients require RRT during the ICU stay. RRT has long been used as supportive treatment of Acute Kidney Injury (AKI), and has traditionally focused on averting the life threatening derangements associated with kidney failure (i.e. metabolic acidosis, hyperkalemia, uremia, and/or fluid overload), while allowing time for organ recovery. In patients with AKI, RRT is regarded as a type of organ support aimed at achieving metabolic homeostasis and preventing fluid overload and new organ failure. The benefits of RRT must be balanced by potential harm, including risks related to vascular access, infections and anticoagulation.
A number of strategies for RRT may be used. RRT can be applied intermittently (IRRT), e.g. intermittent haemodialysis (IHD) or continuously (CRRT), as in continuous venovenous haemofiltration (CVVHF). IRRT was defined as any form of RRT [haemodialysis (HD), haemofiltration (HF), haemodiafiltration (HDF), isolated ultrafiltration (UF)] prescribed for a period of < 24 hours. CRRT was defined as any form of RRT (HD, HF, HDF, UF) intended to run on a continuous basis until recovery of renal function.
References
Other data
| Title | Renal Replacement Therapy In Acute Kidney Injury | Other Titles | العلاج بالغسيل الكلوي فى مرضى القصور الكلوي الحاد | Authors | Ramy Sameer Abbas Mohammed | Issue Date | 2017 |
Recommend this item
Similar Items from Core Recommender Database
Items in Ain Shams Scholar are protected by copyright, with all rights reserved, unless otherwise indicated.