• Intensive care medicine · Oct 2022

    Review

    Delivering optimal renal replacement therapy to critically ill patients with acute kidney injury.

    • Ron Wald, William Beaubien-Souligny, Rahul Chanchlani, Edward G Clark, Javier A Neyra, Marlies Ostermann, Samuel A Silver, Suvi Vaara, Alexander Zarbock, and Sean M Bagshaw.
    • Division of Nephrology, St. Michael's Hospital and the University of Toronto, 61 Queen Street East, 9-140, Toronto, ON, M5C 2T2, Canada. Ron.wald@unityhealth.to.
    • Intensive Care Med. 2022 Oct 1; 48 (10): 136813811368-1381.

    AbstractCritical illness is often complicated by acute kidney injury (AKI). In patients with severe AKI, renal replacement therapy (RRT) is deployed to address metabolic dysfunction and volume excess until kidney function recovers. This review is intended to provide a comprehensive update on key aspects of RRT prescription and delivery to critically ill patients. Recently completed trials have enhanced the evidence base regarding several RRT practices, most notably the timing of RRT initiation and anticoagulation for continuous therapies. Better evidence is still needed to clarify several aspects of care including optimal targets for ultrafiltration and effective strategies for RRT weaning and discontinuation.© 2022. Springer-Verlag GmbH Germany, part of Springer Nature.

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