This practical guide provides the reader with answers to important clinically relevant questions regarding the evaluation and management of acute kidney injury (AKI). All aspects of critical care nephrology are covered, from pathophysiology and diagnosis to prevention and treatment. The questions considered relate to a wide range of issues, such as: How do I diagnose AKI? How can I protect the kidney in clinical practice? How do I manage patients with AKI? When should I initiate and how do I perform renal replacement therapy (RTT)? Which type of RTT is most appropriate for my patient? Should I give specific nutrients? In addition to providing practical guidelines and treatment algorithms, the book includes calculators for continuous RRT and anticoagulant dosing. The authors are internationally renowned experts in the fields of Intensive Care Medicine and Nephrology and all contributions are written in a clear and concise style and have been peer reviewed. Acute Nephrology for the Critical Care Physician will serve as a very useful source for intensivist internists, anesthesiologists and nephrologists involved in the management and treatment of critically ill patients at risk of or affected by AKI.
Table of Contents
1. Acute Kidney Injury (AKI): Definitions and clinical context (Z. Ricci).- 2. Epidemiology of AKI (E. Hoste).- 3. Pathophysiology of AKI: Ischemia/reperfusion, Sepsis/inflammation, Toxicity, Vascular (A.B.J. Groeneveld,).- 4. Diagnostic work-up of the patient with suspected AKI: Oliguria, Metabolic acidosis (J. Prowle).- 5. Uremic toxins (R. Vanholder).- 6. The kidney and other organs/conditions: Heart, Cardiorenal syndromes, Uremic pericarditis, Lungs/Asthma renale, Liver/Hepatorenal syndrome, Gut/Uremic mucositis/GI permeability, Brain, Coagulation, Pregnancy (S. Bagshaw).- 7. Biomarkers for AKI (M. Ostermann).- 8. Prevention of AKI and protection of the kidney: Fluids, Vasopressors, Inotropes and vasodilators, Anti-inflammatory treatment, Antioxidants; Prevention of contrast associate nephropathy (M. Joannidis, co-authors ICM paper).- 9. Timing of renal replacement therapy (RRT) in AKI (S. Bagshaw,).- 10. Dosing of RRT (C.S.C. Bouman).- 11. Types of RRT: Continuous vs. intermittent, Convection vs. diffusion, Predilution vs. Postdilution, SLED, Replacement fluids, Membranes, Biocompatability (L.G. Forni).- 12. Anticoagulation for RRT: Heparin, Citrate, HIT (H.M. Oudemans).- 13. Metabolic aspects of continuous renal replacement therapy (CRRT): Control of acidosis, Control of electrolytes, Bioenergetic gain and loss, Loss of (micro)nutrient, Nutrition (O. Joannes Boyeau).- 14. CRRT: in sepsis, after cardiac surgery (P. Honore).- 15. CRRT in the pediatric population (Z. Ricci).- 16. Drug removal by CRRT and drug dosing in the patient on CRRT (M. Schetz).- 17. CRRT for intoxications (D. Cruz).- 18. How to avoid harm in the patient with AKI: summary of key points of previous chapters (H.M. Oudemans).- 19. Follow-up and long-term renal outcomes of patients surviving AKI (J. Prowle).