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Akutes Nierenversagen:Prophylaxe und Therapie

  • Conference paper
Notfalltherapie

Part of the book series: Interdisziplinäre Gastroenterologie ((GASTROENTEROLOG))

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Zusammenfassung

Trotz vieler Verbesserungen der Dialysetherapie und der flankierenden Behandlungsmaßnahmen liegt die Mortalität bei akuter Niereninsuffizienz noch immer um 50% [64]. Dieses scheinbar ungünstige Behandlungs-resultat könnte auf eine Änderung der befallenen Patientenkollektive zurückzuführen sein. Mit der Verbesserung vieler chirurgischer Maßnahmen und der Intensivmedizin wird heute die akute Niereninsuffizienz bei manchen Notfallpatienten, die in früheren Jahren eine solche Komplikation entwickelt hätten, vermieden, während umgekehrt viele Schwerkranke, die früher gestorben wären, am Leben erhalten werden und eine Niereninsuffizienz entwickeln. Deshalb ist heute der typische, von Niereninsuffizienz befallene Patient über 60 Jahre alt und hat in den meisten Fällen kürzlich einen chirurgischen Eingriff am Abdomen durchgemacht. Eine akute Niereninsuffizienz ist ferner kein seltenes Ereignis bei Pankreatitis, Cholangitis, Ileus, Peritonitis oder bei anderen schweren abdominalen Erkrankungen, doch ist über ihre Epidemiologie noch zu wenig bekannt. In einer Studie fand sich bei 4% der Patienten einer Intensivstation eine akute Niereninsuffizienz im Gefolge einer Pankreatitis, Peritonitis oder eines Ileus [56]. In einer anderen Studie wurden über einen Zeitraum von 13 Jahren 235 Fälle von akuter Niereninsuffizienz bei postoperativen Patienten beschrieben [51].

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Authors
  1. J. J. Gonvers
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  2. H. R. Brunner
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Editors and Affiliations

  1. Klinik und Poliklinik für Allgemeinchirurgie, der Georg-August-Universität Göttingen, Robert-Koch-Straße 40, D-3400, Göttingen, Germany

    Jörg Rüdiger Siewert

  2. Medizinische Klinik, Stadtspital Triemli, Birmendorferstraße 497, CH-8063, Zürich, Switzerland

    André Louis Blum

  3. Abteilung für Allgemeine Chirurgie mit Poliklinik, Chirurgische Universitätsklinik, Hugstetterstraße 55, D-7800, Freiburg, Germany

    Eduard H. Farthmann

  4. Abteilung Gastroenterologie und Stoffwechsel, Medizinische Universitätsklinik, Robert-Koch-Straße 40, D-3400, Göttingen, Germany

    Paul G. Lankisch

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Gonvers, J.J., Brunner, H.R. (1982). Akutes Nierenversagen:Prophylaxe und Therapie. In: Siewert, J.R., Blum, A.L., Farthmann, E.H., Lankisch, P.G. (eds) Notfalltherapie. Interdisziplinäre Gastroenterologie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-68497-5_3

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  • DOI: https://doi.org/10.1007/978-3-642-68497-5_3

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