Summary
Acute kidney injury in the ICU is increasing dramatically worldwide,
making the need for renal replacement therapy (RRT) greater than
ever. Unresolved issues are questions like when do we start RRT
and how do we measure its dose. Several recent trials could show
that the relationship between dose of RRT and survival is not a
linear one, leaving it to the discretion of the nephrologist and/or
intensivist to choose the mean of RRT and its dose in a complex
therapeutic concept for the critically ill patient. Highly efficient
means of RRT eliminate potentially life-saving drugs like antibiotics
to a larger extent than one or two decades ago. As sepsis is responsible
for the onset of acute renal failure in more than half of the patients
careful adjustment (i. e. increase) of the dose of antibiotics
is crucial to avoid under-dosing of these drugs. This holds also
true for the nutritional support of these patients as increasing
the dose of renal replacement therapy also enhances the elimination
of nutrients.
Schlüsselwörter
akutes Nierenversagen - Nierenersatztherapie - Dialysedosis
Keywords
acute kidney injury - renal replacement injury - dialysis frequency
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R57
Priv.-Doz. Dr. med. Jan T. Kielstein , FASN
Abteilung Nieren-
und Hochdruckerkrankungen, Medizinische Hochschule Hannover
Carl-Neuberg-Str. 1
30625 Hannover
Phone: 0511/532-6319
Fax: 0511/532-4005
Email: Kielstein@yahoo.com