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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, th...
Acute kidney injury is defined as an abrupt change in serum creatinine and/or urine output, and a majority of patients admitted to the ICU have some evidence of the disorder. Unfortunately, treatment for this complex syndrome is as yet lacking and understanding is limited. An interdisciplinary panel of experts has contributed to this volume, illuminating some of the fundamental and complex aspects of the disorder ranging from pathophysiology to treatment, from emerging biomarkers to genetic polymorphisms. Other contributions focus on immunological issues or the many complications of acute kidney injury and co-morbid conditions encountered, covering the fundamentals as well as the latest deve...
Acute Kidney Injury (AKI) is a complex syndrome that is prevalent among hospitalized patients. In recent years, occurrence of AKI events has risen due to a growing susceptibility of fragile and elderly subjects and an increase in the use of complex procedures such as cardiovascular surgery and imaging techniques. Exposure to potentially nephrotoxic drugs, such as new chemotherapeutic agents, is also proving to be a cause of AKI. This book summarizes recent advances in various settings. A reappraisal of current definitions and staging classifications for AKI in the literature is followed by a description of new criteria for identifying patients at risk and characterizing early kidney damage b...
Acute kidney injury (AKI) is a serious and as yet incompletely understood disorder in which sudden impairment of kidney function occurs secondary to one or more of a variety of underlying conditions. This disorder is very common in (elderly) ICU patients and is associated with very high mortality. Many of those who survive suffer from permanent kidney failure and other long-term morbidities, which may include cardiovascular disease and immune dysfunction. Epidemiologic evidence suggests that AKI is not a single disease, but a syndrome comprised of multiple, often coexisting, etiologies. Being usually part of multiorgan failure syndrome, it calls for multiple organ support therapy.The publication at hand contains sections on prerenal azotemia syndromes, dying ‘of’ or ‘with’ AKI, pathophysiology of sepsis-induced acute kidney injury, developments in prevention / treatment / rehabilitation, and renal support. Reporting the latest recommendations from experts, it provides valuable information for those that are interested in understanding the disorder and its treatment options.
Critical care nephrology is an emerging multidisciplinary science in which the competences of different specialists are merged to provide a unified diagnostic and therapeutic approach to the critically ill patient. The volume at hand places great emphasis on cardiorenal syndromes and the multidisciplinary collaboration between cardiology and nephrology. Several contributions describe the cardiorenal syndrome in its different varieties and subtypes and report the results from the most recent Acute Dialysis Quality Initiative Consensus Conference, as well as proposing new diagnostic approaches based on early biomarkers of AKI. Other papers discuss advances in technology for renal replacement therapy and multiple organ support therapy. Moreover, special emphasis is placed on the potential role of extracorporeal therapies in patients affected by H1N1 influenza, and a summary of the most recent trials in the field is included. Containing the proceedings of the 2010 International Vicenza Course on Critical Care Nephrology, this publication is a state-of-the-art appraisal of today's technology and current issues related to cardiorenal syndromes.
Associated with both acute kidney injury (AKI) and cardio-renal syndromes (CRS), new biomarkers represent both a popular area of investigation and a new opportunity for advancement of therapy. This book contains the resolutions of the most recent ADQI conferences on biomarkers in AKI (Dublin) and on cardio-renal syndromes (Venice). The first part answers specific questions about new biomarkers and their use and utility in AKI: What are the most suitable candidate molecules and physiologic measures, how solid and evidence based is the discovery phase? How can we incorporate the new biomarkers in the AKI conceptual model describing the evolution from susceptibility to insult, decreased GFR and...
Acute kidney failure is an important clinical area in the intensive care unit setting. An estimated 5–20% of critically ill patients experience an episode of acute kidney failure during the course of their illness, and about 5% of patients admitted to an ICU will eventually require renal replacement therapy. In these patients, in-hospital mortality is extremely high, exceeding 50%. Thus, the early detection and causal treatment of acute kidney problems is vitally important for a successful outcome. Written by internationally renowned experts, this clinical reference offers helpful advice with the most recent information on the definition, epidemiology, pathophysiology, and clinical causes ...
Continuous renal replacement therapies (CRRT) started off as an alternative to hemo- or peritoneal dialysis. Today's machines and techniques are the result of 4 decades of developments, studies, and practices which can be divided into 4 distinct stages: exploration and development; birth of a new specialty called critical care nephrology; design of specific new devices and machines; and interaction among various specialists to adapt extracorporeal therapies for multiple organ support and sepsis. This book features contributions from prominent CRRT experts from around the world. It is an important tool for educating a new generation of nephrologists and intensivists. At the same time, it provides the most advanced CRRT users with the latest technological information, the most updated clinical evidence, and the personal opinion of key leaders who contributed to the last 40 years of history in the field.
Acute kidney injury (AKI) is a serious disorder in which sudden impairment of kidney function occurs secondary to one or more of a variety of underlying conditions and exposures. It is very common in (elderly) ICU patients and associated with very high mortality. Many of those who survive suffer from permanent kidney failure and other long-term morbidities. Renowned experts from around the world have contributed to this new publication, creating a succinct yet complete review of the most controversial aspects of AKI. The topics range from epidemiology and basic science to pathophysiology and clinical issues. It is intended as a concise reference work for physicians and nurses who deal with AKI in clinical nephrology and intensive care wards on a daily basis.
Fluid overload is often observed in patients with heart failure and secondary oliguric states. A thorough assessment of the fluid status of the patient may help guide the therapy and prevent complications induced by inappropriate therapeutic strategies.The present publication is divided into four parts: Definition and Classification, Pathophysiology, Diagnosis and Therapy. In the first section, the authors present new definitions for heart failure, acute kidney injury and cardiorenal syndromes to facilitate the process of understanding the complex link between the heart and the kidney. Subsequently, different conditions leading to fluid overload are described, followed by an account of emerging diagnostic tools, therapies and technologies devoted to the treatment of patients with severe fluid-related disorders. Clearly structured and written, the present book is a practical tool for physicians and professionals involved in the management and care of patients with combined heart and kidney disorders. Moreover, it also serves as a reference textbook for medical students, residents and fellows dealing in everyday practice with fluid overloaded and oliguric patients.