By Heleen M. Oudemans-van Straaten, Lui G. Forni, A.B. Johan Groeneveld, Sean M. Bagshaw, Michael Joannidis
This functional advisor offers the reader with solutions to special clinically correct questions in regards to the overview and administration of acute kidney damage (AKI). All elements of severe care nephrology are coated, from pathophysiology and prognosis to prevention and therapy. The questions thought of relate to a variety of concerns, reminiscent of: How do I diagnose AKI? How am i able to shield the kidney in medical perform? How do I deal with sufferers with AKI? whilst may still I begin and the way do I practice renal alternative treatment (RTT)? which kind of RTT is appropriate for my sufferer? should still I provide particular food? as well as offering functional directions and remedy algorithms, the ebook comprises calculators for non-stop RRT and anticoagulant dosing. The authors are across the world well known specialists within the fields of in depth Care drugs and Nephrology and all contributions are written in a transparent and concise variety and feature been peer reviewed. Acute Nephrology for the serious Care Physician will function a truly helpful resource for intensivist internists, anesthesiologists and nephrologists all for the administration and remedy of significantly ailing sufferers susceptible to or laid low with AKI.
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Extra info for Acute Nephrology for the Critical Care Physician
Kidney Int. 2011;80(1):17–28. 40. Srisawat N, Murugan R, Lee M, et al. Plasma neutrophil gelatinase-associated lipocalin predicts recovery from acute kidney injury following community-acquired pneumonia. Kidney Int. 2011;80(5):545–52. 41. Srisawat N, Wen X, Lee M, et al. Urinary biomarkers and renal recovery in critically ill patients with renal support. Clin J Am Soc Nephrol. 2011;6(8):1815–23. 42. Schneider AG, Bellomo R, Bagshaw SM, et al. Choice of renal replacement therapy modality and dialysis dependence after acute kidney injury: a systematic review and meta-analysis.
1 Introduction Acute kidney injury (AKI) is estimated to complicate around 5 % of critical care admissions . AKI frequently occurs in the context of multiple organ failure and entails mortality rates in excess of 40 % despite appropriate therapy . Etiologies for AKI are varied and multiple factors often coexist in critically ill patients. While sepsis and nephrotoxin exposure are major risk factors for AKI in the ICU, direct ischemia/reperfusion (I/R) injury may also play a role, especially in hypovolemic and cardiogenic shock.
Conversely, activation of the lipoxygenase pathway during sepsis yields leukotrienes having vasoconstrictive properties, which adversely interfere with the filtration coefficient. Their blockade may be beneficial for renal perfusion and function. Inhibition of the cyclooxygenase-derived compounds by non-steroidal anti-inflammatory drugs (NSAIDs) reduces renal blood flow during experimental sepsis, suggesting a predominantly vasodilating effect of prostaglandins generated via cyclooxygenase in the kidney.
Acute Nephrology for the Critical Care Physician by Heleen M. Oudemans-van Straaten, Lui G. Forni, A.B. Johan Groeneveld, Sean M. Bagshaw, Michael Joannidis
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