Renal Replacement Therapy in the Critical Care Setting
Renal replacement therapy (RRT) is frequently required to manage critically ill patients with acute kidney injury (AKI). There is limited evidence to support the current practice of RRT in intensive care units (ICUs). Recently published randomized control trials (RCTs) have further questioned our un...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Critical Care Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2019/6948710 |
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| author | Adeel Rafi Ahmed Ayanfeoluwa Obilana David Lappin |
| author_facet | Adeel Rafi Ahmed Ayanfeoluwa Obilana David Lappin |
| author_sort | Adeel Rafi Ahmed |
| collection | DOAJ |
| description | Renal replacement therapy (RRT) is frequently required to manage critically ill patients with acute kidney injury (AKI). There is limited evidence to support the current practice of RRT in intensive care units (ICUs). Recently published randomized control trials (RCTs) have further questioned our understanding of RRT in critical care. The optimal timing and dosing continues to be debatable; however, current evidence suggests delayed strategy with less intensive dosing when utilising RRT. Various modes of RRT are complementary to each other with no definite benefits to mortality or renal function preservation. Choice of anticoagulation remains regional citrate anticoagulation in continuous renal replacement therapy (CRRT) with lower bleeding risk when compared with heparin. RRT can be used to support resistant cardiac failure, but evolving therapies such as haemoperfusion are currently not recommended in sepsis. |
| format | Article |
| id | doaj-art-a3e5a28e0b0d41768115a07c73418610 |
| institution | Kabale University |
| issn | 2090-1305 2090-1313 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Critical Care Research and Practice |
| spelling | doaj-art-a3e5a28e0b0d41768115a07c734186102025-02-03T01:27:42ZengWileyCritical Care Research and Practice2090-13052090-13132019-01-01201910.1155/2019/69487106948710Renal Replacement Therapy in the Critical Care SettingAdeel Rafi Ahmed0Ayanfeoluwa Obilana1David Lappin2MB BCh BAO MRCPI MRCP(UK) PGDip (ClinEd), Holder of European Certificate in Nephrology, University Hospital Galway, Galway, IrelandMB BCh BAO MRCPI, Specialist Registrar in Nephrology, University Hospital Galway, Galway, IrelandMB BCh FRCPI PhD (NUI), Consultant Nephrologist, University Hospital Galway, Galway, IrelandRenal replacement therapy (RRT) is frequently required to manage critically ill patients with acute kidney injury (AKI). There is limited evidence to support the current practice of RRT in intensive care units (ICUs). Recently published randomized control trials (RCTs) have further questioned our understanding of RRT in critical care. The optimal timing and dosing continues to be debatable; however, current evidence suggests delayed strategy with less intensive dosing when utilising RRT. Various modes of RRT are complementary to each other with no definite benefits to mortality or renal function preservation. Choice of anticoagulation remains regional citrate anticoagulation in continuous renal replacement therapy (CRRT) with lower bleeding risk when compared with heparin. RRT can be used to support resistant cardiac failure, but evolving therapies such as haemoperfusion are currently not recommended in sepsis.http://dx.doi.org/10.1155/2019/6948710 |
| spellingShingle | Adeel Rafi Ahmed Ayanfeoluwa Obilana David Lappin Renal Replacement Therapy in the Critical Care Setting Critical Care Research and Practice |
| title | Renal Replacement Therapy in the Critical Care Setting |
| title_full | Renal Replacement Therapy in the Critical Care Setting |
| title_fullStr | Renal Replacement Therapy in the Critical Care Setting |
| title_full_unstemmed | Renal Replacement Therapy in the Critical Care Setting |
| title_short | Renal Replacement Therapy in the Critical Care Setting |
| title_sort | renal replacement therapy in the critical care setting |
| url | http://dx.doi.org/10.1155/2019/6948710 |
| work_keys_str_mv | AT adeelrafiahmed renalreplacementtherapyinthecriticalcaresetting AT ayanfeoluwaobilana renalreplacementtherapyinthecriticalcaresetting AT davidlappin renalreplacementtherapyinthecriticalcaresetting |