Premium
Renal replacement therapy in the critically ill patient with acute kidney injury
Author(s) -
LEWINGTON Andrew J. P.
Publication year - 2007
Publication title -
hemodialysis international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.658
H-Index - 47
eISSN - 1542-4758
pISSN - 1492-7535
DOI - 10.1111/j.1542-4758.2007.00201.x
Subject(s) - medicine , renal replacement therapy , acute kidney injury , intensive care medicine , interim , clinical trial , critically ill , modalities , hemodialysis , social science , archaeology , sociology , history
The mortality of patients with acute renal failure (ARF) has remained unacceptably high for many years, with renal replacement therapy (RRT) remaining the mainstay of treatment. Clinical research has hitherto been hindered by a lack of a universal definition. However, changes are upon us in the shape of a new term, acute kidney injury (AKI), proposed to encompass the spectrum of ARF, along with a new definition and staging system. There is a renewed optimism that the establishment of clinical databases and the utilization of new clinical biomarkers will catalyze the development of new therapeutic strategies. In the interim, we must optimize the delivery of RRT to patients with AKI. It is remarkable how few studies are currently available in the literature to guide medical practitioners on the key issues of initiation, modality, type of buffer, dose of RRT, vascular access, and anticoagulation. On the horizon, the outcomes of two major clinical trials comparing doses and modalities of RRT in AKI are eagerly awaited.