Renal Literature Summaries
Optimal dose of renal replacement therapy (RRT) is controversial... the definition of dose in clinical practice is also a little controversial!
AKI is the entire spectrum of disease (mild -> severe), and can be defined as an abrupt (1 to 7 days) and sustained (more than 24 hours) decrease in kidney function. Mortality of critically patients with acute renal failure is high (50%–60%)
Acute kidney injury (AKI) is a common problem in the critically ill associated with increased morbidity and mortality
AKI can be defined as an abrupt (1 to 7 days) and sustained (more than 24 hours) decrease in kidney function. The ADQI formulated the RIFLE criteria in 2004 to allow for AKI to be objectively and uniformly defined.
Renal Transplant; commonest transplant; anastamosed to common iliac artery and vein in the pelvis. the ureter is plumbed into the bladder; allows ease of access for palpation and biopsy
Renal replacement therapy: Fluid Management
End-stage renal failure has multiple implications for ICU management
Haemoperfusion: Renal replacement therapy (RRT) using an adsorbent cartridge to remove circulating toxins
Hepatorenal Syndrome = profound oliguria and Na+ retention in the setting of severe liver dysfunction (cirrhosis or fulminant liver failure); usually fatal unless liver transplant performed. RRT can prevent advancement of condition
Renal replacement therapy (RRT): Troubleshooting
Urosepsis is a severe infection, distinguishing it from other urinary tract infections including mild pyelonephritis and accounts for ~5% of severe sepsis; whereas UTIs account for ~40% of nosocomial infections