Intensivmedizin up2date 2015; 11(03): 229-244
DOI: 10.1055/s-0034-1392638
Internistische Intensivmedizin
© Georg Thieme Verlag KG Stuttgart · New York

Akute Nierenschädigung

Carsten Hafer
,
Jan T. Kielstein
Further Information

Publication History

Publication Date:
29 July 2015 (online)

Kernaussagen
  • Bereits leichtgradige Nierenfunktionseinbußen gehen mit einer erhöhten Morbidität und Mortalität einher.

  • Frühzeitig sollte man eine nephrologische Konsultation anberaumen.

  • Urinmikroskopie und Sonografie sind wesentlich Elemente der nephrologischen Diagnostik.

  • Biomarker haben derzeit allenfalls einen begrenzten klinischen Nutzen.

  • Frühzeitige hämodynamische Optimierung mit chloridarmen, bilanzierten Vollelektrolytlösungen

  • Bei unzureichender Besserung und Anurie ist eine restriktive Volumentherapie vorteilhaft.

  • Katecholamin der Wahl ist nach derzeitigem Kenntnisstand Noradrenalin.

  • Überwachung der verordneten Nierenersatztherapie und der potenziellen Komplikationen.

 
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