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Practical approach to detection and management of acute kidney injury in critically ill patient
BACKGROUND: Acute kidney injury (AKI) is a common complication in critically ill patients and is associated with high morbidity and mortality. This paper provides a critical review of the etiologies of AKI and a systematic approach toward its diagnosis and management with emphasis on fluid volume as...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2017
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5603084/ https://www.ncbi.nlm.nih.gov/pubmed/28932401 http://dx.doi.org/10.1186/s40560-017-0251-y |
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author | Mohsenin, Vahid |
author_facet | Mohsenin, Vahid |
author_sort | Mohsenin, Vahid |
collection | PubMed |
description | BACKGROUND: Acute kidney injury (AKI) is a common complication in critically ill patients and is associated with high morbidity and mortality. This paper provides a critical review of the etiologies of AKI and a systematic approach toward its diagnosis and management with emphasis on fluid volume assessment and the use of urine biochemical profile and microscopy in identifying the nature and the site of kidney injury. MATERIALS AND METHODS: The search of PubMed and selection of papers had employed observational designs or randomized control trials relevant to AKI. RESULTS: AKI is defined by the rate of rise of serum creatinine and a decline in urine output. The pathophysiology is diverse and requires a careful and systematic assessment of predisposing factors and localization of site of injury. The majority of AKIs are due to prerenal causes such as fluid volume deficit, sepsis, or renal as in acute tubular injury. The use of central venous and arterial blood pressure monitoring and inferior vena cava echocardiography complemented by urine analysis and microscopy allows assessment of fluid volume status and AKI etiology. CONCLUSIONS: Timely intervention by avoidance of fluid volume deficit and nephrotoxic agents and blood pressure support can reduce the incidence of AKI in critically ill patients. |
format | Online Article Text |
id | pubmed-5603084 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-56030842017-09-20 Practical approach to detection and management of acute kidney injury in critically ill patient Mohsenin, Vahid J Intensive Care Review BACKGROUND: Acute kidney injury (AKI) is a common complication in critically ill patients and is associated with high morbidity and mortality. This paper provides a critical review of the etiologies of AKI and a systematic approach toward its diagnosis and management with emphasis on fluid volume assessment and the use of urine biochemical profile and microscopy in identifying the nature and the site of kidney injury. MATERIALS AND METHODS: The search of PubMed and selection of papers had employed observational designs or randomized control trials relevant to AKI. RESULTS: AKI is defined by the rate of rise of serum creatinine and a decline in urine output. The pathophysiology is diverse and requires a careful and systematic assessment of predisposing factors and localization of site of injury. The majority of AKIs are due to prerenal causes such as fluid volume deficit, sepsis, or renal as in acute tubular injury. The use of central venous and arterial blood pressure monitoring and inferior vena cava echocardiography complemented by urine analysis and microscopy allows assessment of fluid volume status and AKI etiology. CONCLUSIONS: Timely intervention by avoidance of fluid volume deficit and nephrotoxic agents and blood pressure support can reduce the incidence of AKI in critically ill patients. BioMed Central 2017-09-16 /pmc/articles/PMC5603084/ /pubmed/28932401 http://dx.doi.org/10.1186/s40560-017-0251-y Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Review Mohsenin, Vahid Practical approach to detection and management of acute kidney injury in critically ill patient |
title | Practical approach to detection and management of acute kidney injury in critically ill patient |
title_full | Practical approach to detection and management of acute kidney injury in critically ill patient |
title_fullStr | Practical approach to detection and management of acute kidney injury in critically ill patient |
title_full_unstemmed | Practical approach to detection and management of acute kidney injury in critically ill patient |
title_short | Practical approach to detection and management of acute kidney injury in critically ill patient |
title_sort | practical approach to detection and management of acute kidney injury in critically ill patient |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5603084/ https://www.ncbi.nlm.nih.gov/pubmed/28932401 http://dx.doi.org/10.1186/s40560-017-0251-y |
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