Das akute Nierenversagen

Abstract

Acute kidney injury (AKI) is an important part of renal diseases and a common clinical problem. AKI is an acute decline in renal function. Due to a lack of therapeutic options, prevention and optimal management of patients with AKI are the most important strategies. Although seldom the sole cause of patients’ death, AKI is associated with a significant increase in mortality. Our objective is to draw the attention towards the prevention of AKI of non-renal causes.

Das akute Nierenversagen (ANV) ist ein wichtiges Symptom primärer Nierenerkrankungen und die häufigste nephrologische Komplikation extrarenaler Erkrankungen [1] [2]. Die besondere Bedeutung liegt in der hohen Sterblichkeit der Patienten mit ANV während eines Krankenhausaufenthaltes [3] [4]. Das Ziel dieser Übersicht ist es, für das Krankheitsbild und seine Komplikationen zu sensibilisieren und durch Identifizieren von Risikopatienten und Ergreifen von präventiven Maßnahmen die ANV-Inzidenz zu senken.

Schlüsselworter

akutes Nierenversagen - akute Tubulusnekrose - Nephrotoxine - Volumendepletion - Prävention

Key words

acute renal failure - acute kidney injury - acute tubular necrosis - nephrotoxicity - volume depletion - prevention

• Literatur

• 1 Khwaja A. KDIGO clinical practice guidelines for acute kidney injury. Nephron Clin Pract 2012; 120: c179-c184
• 2 Hsu CY. Linking the population epidemiology of acute renal failure, chronic kidney disease and end-stage renal disease. Curr Opin Nephrol Hypertens 2007; 16: 221-226
• 3 Xue JL. Daniels F. Star RA. et al. Incidence and mortality of acute renal failure in Medicare beneficiaries, 1992 to 2001. J Am Soc Nephrol 2006; 17: 1135-1142
• 4 Uchino S. Kellum JA. Bellomo R. et al. Acute renal failure in critically ill patients: a multinational, multicenter study. JAMA 2005; 294: 813-818
• 5 Ali T. Khan I. Simpson W. et al. Incidence and outcomes in acute kidney injury: a comprehensive population-based study. J Am Soc Nephrol 2007; 18: 1292-1298
• 6 Rewa O. Bagshaw SM. Acute kidney injury-epidemiology, outcomes and economics. Nat Rev Nephrol 2014; 10: 193-207
• 7 KDIGO Acute Kidney Injury Work Group. KDIGO Clinical Practice Guideline for Acute Kidney Injury. Kidney Int 2012; 2: 1-138
• 8 Susantitaphong P. Cruz DN. Cerda J. et al. World incidence of AKI: a meta-analysis. Clin J Am Soc Nephrol 2013; 8: 1482-1493
• 9 Schneider V. Levesque LE. Zhang B. et al. Association of selective and conventional nonsteroidal antiinflammatory drugs with acute renal failure: A population-based, nested case-control analysis. Am J Epidemiol 2006; 164: 881-889
• 10 Saric M. Kronzon I. Cholesterol embolization syndrome. Curr Opin Cardiol 2011; 26: 472-479
• 11 Nash K. Hafeez A. Hou S. Hospital-acquired renal insufficiency. Am J Kidney Dis 2002; 39: 930-936
• 12 Heintz BH. Matzke GR. Dager WE. Antimicrobial dosing concepts and recommendations for critically ill adult patients receiving continuous renal replacement therapy or intermittent hemodialysis. Pharmacotherapy 2009; 29: 562-577
• 13 Rudnick M. Feldman H. Contrast-induced nephropathy: what are the true clinical consequences?. Clin J Am Soc Nephrol 2008; 3: 263-272
• 14 Steiner RW. Interpreting the fractional excretion of sodium. Am J Med 1984; 77: 699-702
• 15 Ho KM. Power BM. Benefits and risks of furosemide in acute kidney injury. Anaesthesia 2010; 65: 283-293
• 16 Mehta RL. Pascual MT. Soroko S. et al. Diuretics, mortality, and nonrecovery of renal function in acute renal failure. JAMA 2002; 288: 2547-2553
• 17 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
• 18 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
• 19 Bucaloiu ID. Kirchner HL. Norfolk ER. et al. Increased risk of death and de novo chronic kidney disease following reversible acute kidney injury. Kidney Int 2012; 81: 477-485
• 20 Coca SG. Singanamala S. Parikh CR. Chronic kidney disease after acute kidney injury: a systematic review and meta-analysis. Kidney Int 2012; 81: 442-448
• 21 Prowle JR. Chua HR. Bagshaw SM. et al. Clinical review: Volume of fluid resuscitation and the incidence of acute kidney injury – a systematic review. Crit Care 2012; 16: 230
• 22 Zarychanski R. Abou-Setta AM. Turgeon AF. et al. Association of hydroxyethyl starch administration with mortality and acute kidney injury in critically ill patients requiring volume resuscitation: a systematic review and meta-analysis. JAMA 2013; 309: 678-688