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Principles of Adult Surgical Critical Care pp 159–168Cite as

Renal Replacement Therapy in the Critically Ill Surgical Patient

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Abstract

The diagnosis of clinically significant acute kidney injury (AKI) among the critically ill surgical population occurs in approximately one in four admissions [1]. About 5 % of all patients admitted to the intensive care unit (ICU), or 1 out of every 20 admissions, require some form of renal replacement therapy (RRT) [1]. Among all critically ill patients who require RRT, the mortality has consistently been around 60 % [2]. Practically speaking, RRT refers to the clearance of excessive electrolytes, toxic solutes, and volume that accumulates in the intravascular and extravascular space in the setting of AKI. Most often, this type of therapy is delivered via a venovenous extracorporeal circuit with a blood pump that drives venous blood through an artificial “kidney” membrane. Less commonly, the peritoneal cavity could be used to exchange electrolytes and solutes in the form of peritoneal dialysis. We will focus our discussion in this chapter mainly on extracorporeal RRT with only a brief section on peritoneal dialysis.

The opinions or assertions contained herein are the private views of the author and are not to be construed as official or as reflecting the views of the Department of the Army or the Department of Defense.

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Author information

Authors and Affiliations

  1. Burn Center, US Army Institute of Surgical Research, Fort Sam Houston, TX, 78258, USA

    Kevin K. Chung MD

  2. Department of Medicine, David Grant Medical Center, Travis AFB, CA, 94535, USA

    Ian J. Stewart MD

Authors
  1. Kevin K. Chung MD
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  2. Ian J. Stewart MD
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Correspondence to Kevin K. Chung MD .

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Editors and Affiliations

  1. Trauma, Surgical Critical Care, Emergency Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA

    Niels D. Martin

  2. Trauma, Surgical Critical Care, Emergency Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA

    Lewis J. Kaplan

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Chung, K.K., Stewart, I.J. (2016). Renal Replacement Therapy in the Critically Ill Surgical Patient. In: Martin, N.D., Kaplan, L.J. (eds) Principles of Adult Surgical Critical Care. Springer, Cham. https://doi.org/10.1007/978-3-319-33341-0_15

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  • DOI: https://doi.org/10.1007/978-3-319-33341-0_15

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