Renal Replacement Therapy: A Practical Approach

Chapter

Abstract

Acute kidney injury (AKI) occurs during hospitalization in 39–57% of adult surgical patients. Among critically ill patients with AKI, 6–7% require some form of renal replacement therapy (RRT) with an associated mortality rate of 50–88%. Among critically ill patients, even the mildest stage of AKI can result in worse clinical outcomes compared to patients who never have AKI. Over the last decade, various diagnostic criteria have been proposed and validated in various populations, including surgical patients. These include the Risk, Injury, Failure, Loss, and End-stage renal failure (RIFLE) criteria, the Acute Kidney Injury Network (AKIN) criteria, and most recently the Kidney Disease Improving Global Outcomes (KDIGO) criteria. The diagnosis and management of AKI in the critically ill surgical population are already discussed in another chapter in this textbook. The purpose of this chapter is to provide a practical review of RRT for the management of metabolic and fluid derangements encountered when caring for surgical patients who develop severe AKI.

Keywords

Continuous Hemofiltration Hemodialysis Renal replacement therapy Acute kidney injury 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Burn Intensive Care Unit, Burn Center, US Army Institute of Surgical Research, Brooke Army Medical CenterJBSA Fort Sam HoustonUSA
  2. 2.Uniformed Services University of the Health SciencesBethesdaUSA
  3. 3.Department of MedicineBrooke Army Medical CenterJBSA-Fort Sam HoustonUSA

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