Contributors
JOHN A. KELLUM, MD, MCCM (Source: Critical Care Clinics)
Source: Critical Care Clinics - March 20, 2021 Category: Intensive Care Source Type: research
Contents
Dana Y. Fuhrman and John A. Kellum (Source: Critical Care Clinics)
Source: Critical Care Clinics - March 20, 2021 Category: Intensive Care Source Type: research
Forthcoming Issues
Toxicology (Source: Critical Care Clinics)
Source: Critical Care Clinics - March 20, 2021 Category: Intensive Care Source Type: research
Starting Kidney Replacement Therapy in Critically III Patients with Acute Kidney Injury
This article discusses how best to provide KRT to critically ill patients with severe AKI. (Source: Critical Care Clinics)
Source: Critical Care Clinics - February 13, 2021 Category: Intensive Care Authors: Sean M. Bagshaw, Ron Wald Source Type: research
Onconephrology
This article provides an overview of acute kidney injury caused by cancer or its treatment, including prerenal, tubular, glomerular diseases, infiltrative disease, tumor lysis syndrome, anticancer drug nephrotoxicity, hematopoietic stem cell transplantation –related acute kidney injury, and cancer-associated thrombotic microangiopathy. (Source: Critical Care Clinics)
Source: Critical Care Clinics - February 13, 2021 Category: Intensive Care Authors: Jaya Kala, Kevin W. Finkel Source Type: research
Starting Kidney Replacement Therapy in Critically Ill Patients with Acute Kidney Injury
This article discusses how best to provide KRT to critically ill patients with severe AKI. (Source: Critical Care Clinics)
Source: Critical Care Clinics - February 13, 2021 Category: Intensive Care Authors: Sean M. Bagshaw, Ron Wald Source Type: research
Kidney Replacement Therapy for Fluid Management
Emerging evidence from observational studies suggests that both slower and faster net ultrafiltration rates during kidney replacement therapy are associated with increased mortality in critically ill patients with acute kidney injury and fluid overload. Faster rates are associated with ischemic organ injury. The net ultrafiltration rate should be prescribed based on patient body weight in milliliters per kilogram per hour, with close monitoring of patient hemodynamics and fluid balance. Randomized trials are required to examine whether moderate net ultrafiltration rates compared with slower and faster rates are associated ...
Source: Critical Care Clinics - February 13, 2021 Category: Intensive Care Authors: Vikram Balakumar, Raghavan Murugan Source Type: research
Acute Kidney Injury in Cardiac Surgery
Acute kidney injury (AKI) occurs frequently after cardiac surgery and is associated with high morbidity and mortality. Although the number of cardiac surgical procedures is constantly growing worldwide, incidence of cardiac surgery –associated AKI is still around 40% and has a significant impact on global health care costs. Numerous trials attempted to identify strategies to prevent AKI and attenuate its detrimental consequences. Effective options remained elusive. Current evidence supports a multimodal risk-stratification a pproach with biomarker-guided management of high-risk patients, perioperative administration of d...
Source: Critical Care Clinics - February 13, 2021 Category: Intensive Care Authors: Christina Massoth, Alexander Zarbock, Melanie Meersch Source Type: research
Sepsis-Associated Acute Kidney Injury
This article discusses the current understanding of S-AKI, recent advances in pathophysiology and biomarker development, and current preventive and therapeutic approaches. (Source: Critical Care Clinics)
Source: Critical Care Clinics - February 13, 2021 Category: Intensive Care Authors: Carlos L. Manrique-Caballero, Gaspar Del Rio-Pertuz, Hernando Gomez Source Type: research
Acute Kidney Disease to Chronic Kidney Disease
Acute kidney injury (AKI) and chronic kidney disease are common interconnected syndromes that represent a public health problem. Acute kidney disease (AKD) is defined as the post-AKI status of acute or subacute kidney damage/dysfunction manifested by persistence of AKI beyond 7 to 90 days after the initial AKI diagnosis. Limited clinical data exist regarding AKD epidemiology but its incidence is observed in ∼25% of AKI survivors. Useful risk-stratification tools to predict risk of AKD and its prognosis are needed. Interventions on fluid management, nephrotoxic exposure, and follow-up care hold promise to ameliorate the...
Source: Critical Care Clinics - February 13, 2021 Category: Intensive Care Authors: Javier A. Neyra, Lakhmir S. Chawla Source Type: research
Acute Kidney Injury in the Intensive Care Unit: Advances in the Identification, Classification, and Treatment of a Multifactorial Syndrome
Acute kidney injury (AKI) remains an epidemic in the intensive care unit (ICU), occurring in more than 50% of patients and with a mortality of 20% to 25%.1 With the development of a standard for defining AKI with the Kidney Disease: Improving Global Outcomes (KDIGO) criteria in 2012,2 arguably no other area of study in critical care medicine has seen as rapid a rise in research efforts when compared with critical care nephrology. In 2020, there is no indication that these efforts are slowing, with still much work to be done. (Source: Critical Care Clinics)
Source: Critical Care Clinics - February 13, 2021 Category: Intensive Care Authors: Dana Y. Fuhrman, John A. Kellum Tags: Preface Source Type: research
Nephrotoxin Stewardship
Drugs are the third leading cause of acute kidney injury (AKI) in critically ill patients. Nephrotoxin stewardship ensures a structured and consistent approach to safe medication use and prevention of patient harm. Comprehensive nephrotoxin stewardship requires coordinated patient care management strategies for safe medication use, ensuring kidney health, and avoiding unnecessary costs to improve the use of nephrotoxins, renally eliminated drugs, and kidney disease treatments. Implementing nephrotoxin stewardship reduces medication errors and adverse drug events, prevents or reduces severity of drug-associated AKI, prevent...
Source: Critical Care Clinics - February 12, 2021 Category: Intensive Care Authors: Sandra L. Kane-Gill Source Type: research
Cardiorenal Syndrome
This article specifically details the classification and the epidemiology, some risk factors, and the pathophysiology of CRS. Some emerging aspects of CRS are also discussed, such as CRS in patients with end-stage heart failure, with mechanical ventricular assistance, and after heart transplantation. Finally, some aspects of pediatric CRS are detailed. (Source: Critical Care Clinics)
Source: Critical Care Clinics - February 12, 2021 Category: Intensive Care Authors: Zaccaria Ricci, Stefano Romagnoli, Claudio Ronco Source Type: research
The Role of Renal Functional Reserve in Predicting Acute Kidney Injury
Renal functional reserve (RFR) is described as the difference between a glomerular filtration rate (GFR) measured at baseline and after protein stimulation. The percent change in GFR after a protein load varies based on differences in experimental conditions, with the use of an oral meat protein stimulus and a creatinine clearance method to quantify GFR showing the greatest RFR. A decline in RFR has been found in numerous patient groups. Recent investigations have suggested that a lower RFR may be associated with an increased risk of acute kidney injury and eventual chronic kidney disease. (Source: Critical Care Clinics)
Source: Critical Care Clinics - February 12, 2021 Category: Intensive Care Authors: Dana Y. Fuhrman Source Type: research
Hepatorenal Syndrome
Development of acute kidney injury in patients with chronic liver disease is common and portends a poor prognosis. Diagnosis remains challenging, as traditional markers, such as serum creatinine, are not reliable. Recent development of novel biomarkers may assist with this. Pathophysiology of this condition is multifactorial, relating to physiologic changes associated with portal hypertension, kidney factors, and systemic inflammatory response. Mainstay of treatment remains use of vasoconstrictors along with albumin. Recent guidelines streamline the selection of patients that will require simultaneous liver and kidney tran...
Source: Critical Care Clinics - December 14, 2020 Category: Intensive Care Authors: Saro Khemichian, Claire Francoz, Francois Durand, Constantine J. Karvellas, Mitra K. Nadim Source Type: research
