Renal Replacement Therapy for Acute Kidney Injury

Abstract

The treatment of established acute kidney injury (AKI) is largely supportive in nature. Renal replacement therapy remains the cornerstone of management for the minority of patients who have severe AKI. Optimization of renal replacement therapy may modulate the high mortality associated with AKI. Recent trials indicated that continuous renal replacement therapy does not confer a survival advantage as compared to intermittent hemodialysis. Furthermore, there is no evidence to support a more intensive strategy of renal replacement therapy in the setting of AKI. There is comparatively limited data regarding the ideal timing of renal replacement therapy initiation and the preferred mode of solute clearance.

Snake Bite–Induced Acute Kidney Injury: Report of a Successful Outcome During Pregnancy

“…3,7 Treatment of established AKI is largely supportive in nature, renal replacement therapy being the cornerstone. 8 Snake bite in pregnancy leading to AKI is not reported in the literature. Our patient is the first reported case of snake bite due to a viper leading to AKI during the pregnancy.…”

Modifying a kidney injury score by including perioperative data Comparison of three predictive scores

“…Whereas Palomba et al defined AKI as an increase of serum creatinine of 50% or a serum creatinine concentration above 2.0 mg/dl (which is close to the criterion used in AKI1), the other authors defined AKI as a GFR < 30 ml/min [6] or the initiation of renal replacement therapy (RRT) [7,9,10]. In particular, the latter criterion lacks objectivity because only a few mandatory indications exist to start renal replacement therapy (RRT) immediately, whereas in the majority of patients with impaired renal function a considerable margin of discretion exists to initiate RRT either earlier or later [20,21].…”

Mannitol is an independent risk factor of acute kidney injury after cerebral trauma: a case–control study

“…11 Different extents of renal impairment may manifest from mild increase of serum creatinine to ARF, which needs renal replacement therapy. 12,13 Previous studies on AKI focus on patients who need renal replacement therapy. The RIFLE staging criteria unify the definition of AKI and classify the extent of renal impairment, which may facilitate the AKI study to more population with mild renal insufficiency.…”