Acute kidney injury and the critically ill

Laura Flood, Alistair Nichol

Research output: Contribution to journalReview ArticleResearchpeer-review

Abstract

Acute renal failure is commonly encountered in the intensive care unit. It is associated with considerable morbidity and mortality. There are many possible aetiologies in the critically ill, including nephrotoxic agents, hypovolaemia and sepsis. While many classification systems for acute renal failure exist, the RIFLE (Risk, Injury, Failure, Loss, End-stage) criteria and the Acute Kidney Injury Network (AKIN) criteria are the most commonly utilized. Many supportive therapies are employed to minimize the degree of renal injury once recognized, such as fluid resuscitation and maintenance of an adequate mean arterial pressure (with the use of inotropes in persistent hypotension despite fluid and treatment of the underlying aetiology). However, if renal failure becomes established, then renal replacement therapy (RRT) may be needed to maintain homoeostasis. While there are no clear guidelines with respect to the ideal mode or timing of RRT, we will discuss pros and cons of the various bedside options.

Original languageEnglish
Pages (from-to)113-118
Number of pages6
JournalAnaesthesia and Intensive Care Medicine
Volume19
Issue number3
DOIs
Publication statusPublished - Mar 2018

Keywords

  • Acute kidney injury
  • critical care
  • intensive care medicine
  • renal failure

Cite this

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Acute kidney injury and the critically ill. / Flood, Laura; Nichol, Alistair.

In: Anaesthesia and Intensive Care Medicine, Vol. 19, No. 3, 03.2018, p. 113-118.

Research output: Contribution to journalReview ArticleResearchpeer-review

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AU - Flood, Laura

AU - Nichol, Alistair

PY - 2018/3

Y1 - 2018/3

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AB - Acute renal failure is commonly encountered in the intensive care unit. It is associated with considerable morbidity and mortality. There are many possible aetiologies in the critically ill, including nephrotoxic agents, hypovolaemia and sepsis. While many classification systems for acute renal failure exist, the RIFLE (Risk, Injury, Failure, Loss, End-stage) criteria and the Acute Kidney Injury Network (AKIN) criteria are the most commonly utilized. Many supportive therapies are employed to minimize the degree of renal injury once recognized, such as fluid resuscitation and maintenance of an adequate mean arterial pressure (with the use of inotropes in persistent hypotension despite fluid and treatment of the underlying aetiology). However, if renal failure becomes established, then renal replacement therapy (RRT) may be needed to maintain homoeostasis. While there are no clear guidelines with respect to the ideal mode or timing of RRT, we will discuss pros and cons of the various bedside options.

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