The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
권호 표지
DOI QR코드

DOI QR Code

Renal Replacement Therapy in Acute Kidney Injury: Indication, Proper Initiation, and Prescription

급성신손상의 신대치 요법: 적응증, 적절한 시기 및 방법

  • Lee, Eun-Kyoung (Department of Internal Medicine, College of Medicine, Dankook University) ;
  • Chang, Jai-Won (Department of Internal Medicine, University of Ulsan College of Medicine)
  • 이은경 (단국대학교 의과대학 내과학교실) ;
  • 장재원 (울산대학교 의과대학 내과학교실)
  • Published : 2012.01.01
⟨ Previous Next ⟩

Abstract

Despite substantial advances in dialytic techniques and machines, acute kidney injury (AKI) requiring renal replacement therapy (RRT) is associated with up to 60% in-hospital mortality. But, there is no full detail of definite RRT to overcome the significant morbidity and mortality of AKI. What is most important in the treatment for AKI is that RRT is not a cause-specific therapy but a life-supportive management. This review discusses the indications of, proper initiation of, and optimal prescription for RRT to improve the survival of the patients with AKI.

Keywords

References

  1. Lassnigg A, Schmidlin D, Mouhieddine M, et al. Minimal changes of serum creatinine predict prognosis in patients after cardiothoracic surgery: a prospective cohort study. J Am Soc Nephrol 2004;15:1597-1605. https://doi.org/10.1097/01.ASN.0000130340.93930.DD
  2. Levy MM, Macias WL, Vincent JL, et al. Early changes in organ function predict eventual survival in severe sepsis. Crit Care Med 2005;33:2194-2201. https://doi.org/10.1097/01.CCM.0000182798.39709.84
  3. Mehta RL, Kellum JA, Shah SV, et al. Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury. Crit Care 2007;11:R31. https://doi.org/10.1186/cc5713
  4. Cruz DN, de Geus HR, Bagshaw SM. Biomarker strategies to predict need for renal replacement therapy in acute kidney injury. Semin Dial 2011;24:124-131. https://doi.org/10.1111/j.1525-139X.2011.00830.x
  5. Gettings LG, Reynolds HN, Scalea T. Outcome in posttraumatic acute renal failure when continuous renal replacement therapy is applied early vs. late. Intensive Care Med 1999;25:805-813. https://doi.org/10.1007/s001340050956
  6. Gibney RT, Bagshaw SM, Kutsogiannis DJ, Johnston C. When should renal replacement therapy for acute kidney injury be initiated and discontinued? Blood Purif 2008;26:473-484. https://doi.org/10.1159/000157325
  7. Ronco C, Bellomo R, Homel P, et al. Effects of different doses in continuous veno-venous haemofiltration on outcomes of acute renal failure: a prospective randomised trial. Lancet 2000;356:26-30. https://doi.org/10.1016/S0140-6736(00)02430-2
  8. Bell M, Liljestam E, Granath F, Fryckstedt J, Ekbom A, Martling CR. Optimal follow-up time after continuous renal replacement therapy in actual renal failure patients stratified with the RIFLE criteria. Nephrol Dial Transplant 2005;20:354-360. https://doi.org/10.1093/ndt/gfh581
  9. Bent P, Tan HK, Bellomo R, et al. Early and intensive continuous hemofiltration for severe renal failure after cardiac surgery. Ann Thorac Surg 2001;71:832-837. https://doi.org/10.1016/S0003-4975(00)02177-9
  10. Elahi MM, Lim MY, Joseph RN, Dhannapuneni RR, Spyt TJ. Early hemofiltration improves survival in post-cardiotomy patients with acute renal failure. Eur J Cardiothorac Surg 2004;26:1027-1031. https://doi.org/10.1016/j.ejcts.2004.07.039
  11. Demirkilic U, Kuralay E, Yenicesu M, et al. Timing of replacement therapy for acute renal failure after cardiac surgery. J Card Surg 2004;19:17-20. https://doi.org/10.1111/j.0886-0440.2004.04004.x
  12. Ronco C, Brendolan A, d'Intini V, Ricci Z, Wratten ML, Bellomo R. Coupled plasma filtration adsorption: rationale, technical development and early clinical experience. Blood Purif 2003;21:409-416. https://doi.org/10.1159/000073444
  13. Wiedemann HP, Wheeler AP, Bernard GR, et al. Comparison of two fluid-management strategies in acute lung injury. N Engl J Med 2006;354:2564-2575. https://doi.org/10.1056/NEJMoa062200
  14. Payen D, de Pont AC, Sakr Y, et al. A positive fluid balance is associated with a worse outcome in patients with acute renal failure. Crit Care 2008;12:R74. https://doi.org/10.1186/cc6916
  15. Bouchard J, Soroko SB, Chertow GM, et al. Fluid accumulation, survival and recovery of kidney function in critically ill patients with acute kidney injury. Kidney Int 2009;76:422-427. https://doi.org/10.1038/ki.2009.159
  16. Paganini EP, Tapolyai M, Goormastic M, et al. Establishing a dialysis therapy/patient outcome link in intensive care unit acute dialysis for patients with acute renal failure. Am J Kidney Dis 1996;28:S81-S89. https://doi.org/10.1016/S0272-6386(96)90084-0
  17. Schiffl H, Lang SM, Fischer R. Daily hemodialysis and the outcome of acute renal failure. N Engl J Med 2002;346:305-310. https://doi.org/10.1056/NEJMoa010877
  18. Dunham CM. Clinical impact of continuous renal replacement therapy on multiple organ failure. World J Surg 2001;25:669-676. https://doi.org/10.1007/s002680020029
  19. Chang JW, Yang WS, Seo JW, Lee JS, Lee SK, Park SK. Continuous venovenous hemodiafiltration versus hemodialysis as renal replacement therapy in patients with acute renal failure in the intensive care unit. Scand J Urol Nephrol 2004;38:417-421. https://doi.org/10.1080/00365590410031751
  20. Piccinni P, Dan M, Barbacini S, et al. Early isovolaemic haemofiltration in oliguric patients with septic shock. Intensive Care Med 2006;32:80-86. https://doi.org/10.1007/s00134-005-2815-x
  21. Saudan P, Niederberger M, De Seigneux S, et al. Adding a dialysis dose to continuous hemofiltration increases survival in patients with acute renal failure. Kidney Int 2006;70:1312-1317. https://doi.org/10.1038/sj.ki.5001705
  22. Palevsky PM, Zhang JH, O'Connor TZ, et al. Intensity of renal support in critically ill patients with acute kidney injury. N Engl J Med 2008;359:7-20. https://doi.org/10.1056/NEJMoa0802639
  23. Tolwani AJ, Campbell RC, Stofan BS, Lai KR, Oster RA, Wille KM. Standard versus high-dose CVVHDF for ICU-related acute renal failure. J Am Soc Nephrol 2008;19:1233-1238. https://doi.org/10.1681/ASN.2007111173
  24. Bellomo R, Cass A, Cole L, et al. Intensity of continuous renal-replacement therapy in critically ill patients. N Engl J Med 2009;361:1627-1638 https://doi.org/10.1056/NEJMoa0902413
  25. Venkataraman R, Kellum JA, Palevsky P. Dosing patterns for continuous renal replacement therapy at a large academic medical center in the United States. J Crit Care 2002;17:246-250. https://doi.org/10.1053/jcrc.2002.36757
  26. Vesconi S, Cruz DN, Fumagalli R, et al. Delivered dose of renal replacement therapy and mortality in critically ill patients with acute kidney injury. Crit Care 2009;13:R57. https://doi.org/10.1186/cc7784
  27. Claure-Del Granado R, Mehta RL. Assessing and delivering dialysis dose in acute kidney injury. Semin Dial 2011;24: 157-163. https://doi.org/10.1111/j.1525-139X.2011.00833.x