Renal Replacement Therapy in Acute Kidney Injury: Controversies and Consensus

Michael Heung; Lenar Yessayan

doi:10.1016/j.ccc.2016.12.003

Renal Replacement Therapy in Acute Kidney Injury: Controversies and Consensus

Crit Care Clin. 2017 Apr;33(2):365-378. doi: 10.1016/j.ccc.2016.12.003. Epub 2017 Jan 4.

Authors

Michael Heung¹, Lenar Yessayan²

Affiliations

¹ Division of Nephrology, Department of Medicine, University of Michigan, 1500 East Medical Center Drive, SPC 5364, Ann Arbor, MI 48109-5364, USA. Electronic address: mheung@umich.edu.
² Division of Nephrology, Department of Medicine, University of Michigan, 1500 East Medical Center Drive, SPC 5364, Ann Arbor, MI 48109-5364, USA.

PMID: 28284300
DOI: 10.1016/j.ccc.2016.12.003

Abstract

Acute kidney injury (AKI) is a common complication among critically ill patents, and 5% of intensive care unit (ICU) patients require initiation of renal replacement therapy (RRT). In recent years, clinical trials have provided evidence-based guidance for some important aspects of RRT management in patients with AKI, such as dialysis dosing and approaches to anticoagulation in patients undergoing continuous RRT. However, there remain many areas of uncertainty, and delivery of RRT in the ICU requires clinical judgment, flexibility, and an understanding of dialysis principles. This article reviews the components of RRT prescription and provides an update on best practices.

Keywords: Acute kidney injury; Continuous renal replacement therapy; Dialysis.

Publication types

Review

MeSH terms

Acute Kidney Injury / therapy*
Critical Care / methods
Dialysis / methods
Humans
Practice Guidelines as Topic
Renal Replacement Therapy* / methods