Akut Böbrek Yetmezliği
Özet
Akut böbrek yetmezliği hücre dışı volüm ve elektrolitlerin düzensizliği ile sonuçlanan ani böbrek fonksiyon kaybıdır. Mortalitesinin yüksek olması nedeniyle erken tanı konması önemlidir. Erken tanı için en son KDIGO sınıflandırması güncellenmiştir. Yoğun bakımda ABY’nin en sık nedeni renal hipoperfüzyon, sepsis ve nefrotoksik ajanlara maruziyettir. Renal replasman tedavisi böbreğin fonksiyonlarını desteklemek için kullanılan geçici ve kalıcı tedavi modaliteleridir. Yoğun bakımda aralıklı hemodiyaliz veya sürekli renal raplasman tedavisi şeklinde uygulanabilir.
Acute renal failure is a sudden loss of kidney function resulting in irregularity of extracellular volume and electrolytes. Early diagnosis is important because patients have high mortality. The latest KDIGO classification has been updated for early diagnosis. The most common cause of AKI in intensive care is renal hypoperfusion, sepsis and nephrotoxic agents. Renal replacement therapy is a temporary and permanent treatment modality used to support the functions of the kidney. It can be applied in intensive care as intermittent hemodialysis or continuous renal replacement therapy.
Referanslar
E.A. Hoste, S.M. Bagshaw, R. Bellomo, C.M. Cely, R. Colman, D.N. Cruz Epidemiology of acute kidney injury in critically ill patients: the multinational AKI-EPI study. Intensive Care Med, 41 (2015), pp. 1411-1423.
R.L. Mehta, J. Cerda, E.A. Burdmann, M. Tonelli, G. García-García, V. Jha International Society of Nephrology's initiative for acute kidney injury (zero preventable deaths by 2025): a human rights case for nephrology. Lancet, 385 (2015), pp. 2616-2643.
R.L. Mehta, J.A. Kellum, S.V. Shah, et al. & acute kidney injury Network: report of an initiative to improve outcomes in acute kidney injury. Crit care, 11 (2007), p. R31.
A. Khwajan KDIGO clinical practice guidelines for acute kidney injury. Nephron Clin Pract, 120 (2012), pp. c179-c184.
S. Uchino, J.A. Kellum, R. Bellomo, et al. Acute renal failure in critically ill patients: a multinational, multicenter study. J Am Med Assoc, 294 (2005), pp. 813-818.
V. Mohsenin Practical approach to detection and management of acute kidney injury in critically ill patient. J Intensive Care, 5 (2017), p. 57.
M. Joannidis, W. Druml, L.G. Forni, et al. Prevention of acute kidney injury and protection of renal function in the intensive care unit: update. European Society of Intensive Care Medicine (2017).
Kashani, K. et al. Discovery and validation of cell cycle arrest biomarkers in human acute kidney injury. Crit. Care 17, R 25 (2013).
S.M. Bagshaw, R. Wald, N.K.J. Adhikari, et al. Timing of initiation of renal-replacement therapy in acute kidney injury. N Engl J Med, 383 (2020), pp. 240-251.
Zhang K,
Liang KV, Zhang JH, Palevsky PM. Urea reduction ratio may be a simpler approach for measurement of adequacy of intermittent hemodialysis in acute cidney injury. BMC Nefrol 2019; 20:82.
V. Wu, W. Ko, H. Chang, et al. Risk factors of early redialysis after weaning from postoperative acute renal replacement therapy. Intensive Care Med, 34 (2008), pp. 101-108.
Flood, Laura; Nıchol, Alistair. Acute kidney injury and the critically ill. In Anaesthesia & Intensive Care Medicine Volume: 22 Issue 2 (2021) ISSN: 1472-0299 Online ISSN: 1878-7584.
Referanslar
E.A. Hoste, S.M. Bagshaw, R. Bellomo, C.M. Cely, R. Colman, D.N. Cruz Epidemiology of acute kidney injury in critically ill patients: the multinational AKI-EPI study. Intensive Care Med, 41 (2015), pp. 1411-1423.
R.L. Mehta, J. Cerda, E.A. Burdmann, M. Tonelli, G. García-García, V. Jha International Society of Nephrology's initiative for acute kidney injury (zero preventable deaths by 2025): a human rights case for nephrology. Lancet, 385 (2015), pp. 2616-2643.
R.L. Mehta, J.A. Kellum, S.V. Shah, et al. & acute kidney injury Network: report of an initiative to improve outcomes in acute kidney injury. Crit care, 11 (2007), p. R31.
A. Khwajan KDIGO clinical practice guidelines for acute kidney injury. Nephron Clin Pract, 120 (2012), pp. c179-c184.
S. Uchino, J.A. Kellum, R. Bellomo, et al. Acute renal failure in critically ill patients: a multinational, multicenter study. J Am Med Assoc, 294 (2005), pp. 813-818.
V. Mohsenin Practical approach to detection and management of acute kidney injury in critically ill patient. J Intensive Care, 5 (2017), p. 57.
M. Joannidis, W. Druml, L.G. Forni, et al. Prevention of acute kidney injury and protection of renal function in the intensive care unit: update. European Society of Intensive Care Medicine (2017).
Kashani, K. et al. Discovery and validation of cell cycle arrest biomarkers in human acute kidney injury. Crit. Care 17, R 25 (2013).
S.M. Bagshaw, R. Wald, N.K.J. Adhikari, et al. Timing of initiation of renal-replacement therapy in acute kidney injury. N Engl J Med, 383 (2020), pp. 240-251.
Zhang K,
Liang KV, Zhang JH, Palevsky PM. Urea reduction ratio may be a simpler approach for measurement of adequacy of intermittent hemodialysis in acute cidney injury. BMC Nefrol 2019; 20:82.
V. Wu, W. Ko, H. Chang, et al. Risk factors of early redialysis after weaning from postoperative acute renal replacement therapy. Intensive Care Med, 34 (2008), pp. 101-108.
Flood, Laura; Nıchol, Alistair. Acute kidney injury and the critically ill. In Anaesthesia & Intensive Care Medicine Volume: 22 Issue 2 (2021) ISSN: 1472-0299 Online ISSN: 1878-7584.
