Pub Date : 2018-12-08DOI: 10.5772/INTECHOPEN.82503
A. Karkar
Continuous renal replacement therapy (CRRT) is a slow and smooth continuous extracorporeal blood purification. CRRT is usually implemented over 24 h to several days with an aim of gentle removal of fluid overload and excess uremic toxins, where the continuous filtration simulates the continuity of kidney functions. It is usually indicated in critically ill and hemodynamically unstable (adult and pediatric) patients with acute kidney injury (AKI) and/or multiorgan failure, sepsis/shock, acute brain injury, or other causes of increased intracranial pressure or generalized brain edema in intensive care unit (ICU), where such patients cannot tolerate the relatively fast removal of fluids (and solutes) by conventional hemodialysis (HD).
{"title":"Introductory Chapter: Principles and Methods of Acute Therapies","authors":"A. Karkar","doi":"10.5772/INTECHOPEN.82503","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.82503","url":null,"abstract":"Continuous renal replacement therapy (CRRT) is a slow and smooth continuous extracorporeal blood purification. CRRT is usually implemented over 24 h to several days with an aim of gentle removal of fluid overload and excess uremic toxins, where the continuous filtration simulates the continuity of kidney functions. It is usually indicated in critically ill and hemodynamically unstable (adult and pediatric) patients with acute kidney injury (AKI) and/or multiorgan failure, sepsis/shock, acute brain injury, or other causes of increased intracranial pressure or generalized brain edema in intensive care unit (ICU), where such patients cannot tolerate the relatively fast removal of fluids (and solutes) by conventional hemodialysis (HD).","PeriodicalId":410858,"journal":{"name":"Aspects in Continuous Renal Replacement Therapy","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125298876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-11-05DOI: 10.5772/INTECHOPEN.79563
K. Takkavatakarn, P. Susantitaphong, S. Eiam‐Ong
Acute kidney injury (AKI) is one of the most important complications during hospitalization, especially in critically ill patients. Recent data demonstrated that certain biomarkers including pro-inflammatory cytokines are associated with high morbidity and mortality. These biomarkers, most of which have middle molecular weight, and protein-bound uremic toxins are limitedly removed by diffusion mechanism in conventional hemodialysis. Hemodiafiltration (HDF), a new modality that combines convective clearance with diffusion, could effectively enhance removal of middle molecule and protein-bound solutes. Therefore, HDF is increasingly used in several AKI settings such as septic AKI, rhabdomyolysis-associated AKI, myeloma cast nephropathy, and contrast-induced AKI. This chapter summarizes the available HDF techniques including intermittent and continuous modes, and clinical data comprise the benefits of HDF on biomarkers and renal as well as cardiovascular outcomes. Additionally, the topic provides the proposed future directions of HDF in various AKI settings.
{"title":"Hemodiafiltration in Acute Kidney Injury","authors":"K. Takkavatakarn, P. Susantitaphong, S. Eiam‐Ong","doi":"10.5772/INTECHOPEN.79563","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.79563","url":null,"abstract":"Acute kidney injury (AKI) is one of the most important complications during hospitalization, especially in critically ill patients. Recent data demonstrated that certain biomarkers including pro-inflammatory cytokines are associated with high morbidity and mortality. These biomarkers, most of which have middle molecular weight, and protein-bound uremic toxins are limitedly removed by diffusion mechanism in conventional hemodialysis. Hemodiafiltration (HDF), a new modality that combines convective clearance with diffusion, could effectively enhance removal of middle molecule and protein-bound solutes. Therefore, HDF is increasingly used in several AKI settings such as septic AKI, rhabdomyolysis-associated AKI, myeloma cast nephropathy, and contrast-induced AKI. This chapter summarizes the available HDF techniques including intermittent and continuous modes, and clinical data comprise the benefits of HDF on biomarkers and renal as well as cardiovascular outcomes. Additionally, the topic provides the proposed future directions of HDF in various AKI settings.","PeriodicalId":410858,"journal":{"name":"Aspects in Continuous Renal Replacement Therapy","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121304086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-11-05DOI: 10.5772/INTECHOPEN.80625
A. Alkhunaizi
Acute kidney injury (AKI), previously named acute renal failure, is characterized by abrupt deterioration in renal function. The incidence of AKI has increased lately, both in the hospital and community setting. It is estimated that more than 13 million people are affected by AKI annually worldwide. Despite all the advances in the field, AKI still carries a high mortality rate. In addition to mortality, AKI is an important risk factor for the development of chronic kidney disease. In this chapter, various aspects of AKI will be discussed including definition and staging, etiology, pathophysiology, clinical presenta- tion, diagnosis, management, prognosis, and prevention. crisis, disease,
{"title":"Acute Kidney Injury","authors":"A. Alkhunaizi","doi":"10.5772/INTECHOPEN.80625","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.80625","url":null,"abstract":"Acute kidney injury (AKI), previously named acute renal failure, is characterized by abrupt deterioration in renal function. The incidence of AKI has increased lately, both in the hospital and community setting. It is estimated that more than 13 million people are affected by AKI annually worldwide. Despite all the advances in the field, AKI still carries a high mortality rate. In addition to mortality, AKI is an important risk factor for the development of chronic kidney disease. In this chapter, various aspects of AKI will be discussed including definition and staging, etiology, pathophysiology, clinical presenta- tion, diagnosis, management, prognosis, and prevention. crisis, disease,","PeriodicalId":410858,"journal":{"name":"Aspects in Continuous Renal Replacement Therapy","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114244444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-11-05DOI: 10.5772/INTECHOPEN.79853
J. Echeverri, C. Larrarte, M. Huérfano
Acute kidney injury is a common condition in critical care, and continuous extracorporeal therapies have become part of the requirement for multiorgan support in critically ill patients. Availability of continuous renal replacement therapy (CRRT) in a healthcare center can influence the therapy performance and patient ’ s results, and it is challenging to attain high-quality standards in centers without previous experience in CRRTand with new therapy users. This chapter describes the experience of a highly specialized acute renal care service model with emphasis on timely interventions by an exclusive CRRT team, and protocol performance and its impact on optimal clinical and pharmacoeconomic
{"title":"Continuous Renal Replacement Therapy Specialized Teams: A Challenge to Improve Quality Performance","authors":"J. Echeverri, C. Larrarte, M. Huérfano","doi":"10.5772/INTECHOPEN.79853","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.79853","url":null,"abstract":"Acute kidney injury is a common condition in critical care, and continuous extracorporeal therapies have become part of the requirement for multiorgan support in critically ill patients. Availability of continuous renal replacement therapy (CRRT) in a healthcare center can influence the therapy performance and patient ’ s results, and it is challenging to attain high-quality standards in centers without previous experience in CRRTand with new therapy users. This chapter describes the experience of a highly specialized acute renal care service model with emphasis on timely interventions by an exclusive CRRT team, and protocol performance and its impact on optimal clinical and pharmacoeconomic","PeriodicalId":410858,"journal":{"name":"Aspects in Continuous Renal Replacement Therapy","volume":"439 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122888326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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