Surgery pp 597-611 | Cite as

Renal Replacement Therapy

  • John C. L. Wang
  • Roxana M. Bologa
  • Stuart D. Saal


Acute renal failure (ARF) is a commonly anticipated diagnosis in critically ill patients in the intensive care unit (ICU). Its actual frequency varies from less than 10% to approximately 25% in different series including different patient demographics and definitions of ARF.1, 2, 3, 4, 5 The elevations in serum creatinine and urea nitrogen concentrations observed in a majority of these patients (more than 90%) are caused by renal hypoperfusion and related parenchymal dysfunction, the latter referred to as acute tubular necrosis (ATN)3,6 (Tables 33.1, 33.2). Between one-third and one-half of the observed ATN occurs during infection/sepsis, with the rest related to medical-surgical conditions, including hypotension and toxin exposure.3,6 ARF is typically accompanied by a number of comorbidities [i.e., respiratory failure (67%), heart failure (48%), and liver failure (31%)].7 In many series, more than one-half of the patients who develop ARF in the ICU require some form of renal replacement therapy (RRT).3,6,7


Peritoneal Dialysis Acute Renal Failure Renal Replacement Therapy Blood Flow Rate Replacement Fluid 


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Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • John C. L. Wang
    • 1
    • 2
    • 3
    • 4
    • 5
  • Roxana M. Bologa
    • 1
    • 6
  • Stuart D. Saal
    • 1
    • 5
    • 7
    • 8
  1. 1.Departments of Clinical Medicine and SurgeryWeill Cornell Medical CollegeNew YorkUSA
  2. 2.Jack J. Dreyfus Clinic of Rogosin Kidney CenterThe Rogosin InstituteNew YorkUSA
  3. 3.Adoptive Immunotherapy ProgramThe Rogosin InstituteNew YorkUSA
  4. 4.NephrologyThe Rogosin InstituteNew YorkUSA
  5. 5.Renal Consultation ServiceThe Rogosin InstituteNew YorkUSA
  6. 6.Peritoneal DialysisThe Rogosin InstituteNew YorkUSA
  7. 7.Transplantation ProgramThe Rogosin InstituteNew YorkUSA
  8. 8.ApheresisThe Rogosin InstituteNew YorkUSA

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