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Kardiologie up2date 2015; 11(03): 143-147
DOI: 10.1055/s-0034-1392987
DOI: 10.1055/s-0034-1392987
Hotline – Kardiovaskuläre Notfälle
Organersatz auf der Intensivstation – extrakorporaler Nierenersatz
Weitere Informationen
Publikationsverlauf
Publikationsdatum:
28. September 2015 (online)
![](https://www.thieme-connect.de/media/kardiologie-u2d/201503/lookinside/thumbnails/356_10-1055-s-0034-1392987-1.jpg)
Abstract
Acute kidney injury (AKI) can be treated either by continuous forms of extracorporeal treatment (CRRT) or by intermittent hemodialysis (IHD). Treatment should be started early to avoid organ damage. In critically ill patients treated with CRRT a dosage of 25 ml/kg/h should be achieved to avoid further damage and to improve outcome. With intermittent hemodialysis fluid balancing often requires 4 to 5 treatments per week. Regional citrate anticoagulation (RCA) prevents bleeding complications. To optimize patient’s outcome individualized treatment strategies are required rather than prescribing by the traditional ‘one-size-fits-all’ approach.
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Literatur
- 1 Kidney Disease: Improving Global Outcomes Transplant Work Group. KDIGO Clinical practice guidelines for acute kidney injury. Kidney Int Suppl 2012; 2: 1-138
- 2 Schindler R, Hutagalong R, Jörres A et al. Versorgung des akuten Nierenversagens in Deutschland – Eine strukturelle Analyse. Dtsch Med Wochenschr 2014; 139: 1701-1706
- 3 Schmitz M, Heering P, Hutagalong R et al. Versorgung des akuten Nierenversagens auf deutschen Intensivstationen – Analyse der aktuellen Behandlungspraxis. Intensivmedizin und Notfallmedizin 2015; 4: 256-263
- 4 Schneider AG, Bellomo R, Bagshaw SM et al. Choice of renal replacement therapy modality and dialysis after acute kidney injury. A systemic meta analysis and review. Intensive Care Med 2013; 39: 987-997
- 5 Ostermann M, Dickie H, Barrett NA et al. Renal replacement therapy in critically ill patients with acute kidney injury – when to start. Nephrol Dial Transplant 2012; 27: 2242-2248
- 6 Brause M, Neumann A, Schumacher T et al. Effects of filtration-volume of continous venovenous hemofiltration in the treatment of patients with acute renal failure in intensive care units. Crit Care Med 2003; 31: 1-6
- 7 Ronco C, Bellomo R, Homel P et al. Effects of different doses in continuous veno-venous haemofiltration on outcomes of acute renal failure. Lancet 2000; 356: 26-30
- 8 Ronco C. Cardiorenal syndromes. JACC 2008; 52: 1527-1539
- 9 Schwenger V, Remppis BA, Westenfeld R et al. Dialysis and ultrafiltration therapy in patients with cardio-renal syndrome: recommendations of the working group "heart-kidney" of the German Cardiac Society and the German Society of Nephrology. Dtsch Med Wochenschr 2014; 139: 1-8
- 10 Hetzel GR, Schmitz M, Wissing H et al. Regional Zitrate versus systemic heparin for anticoagulation in critically ill patients on continuous venovenous haemofiltration: a prospective randomized multicentre trial. Nephrol Dial Transplant 2011; 26: 232-239