Current state of the art for renal replacement therapy in critically ill patients with acute kidney injury

Intensive Care Med. 2017 Jun;43(6):841-854. doi: 10.1007/s00134-017-4762-8. Epub 2017 Mar 13.

Abstract

Acute kidney injury (AKI) is associated with incremental risk for death and chronic kidney disease and represents a mounting clinical challenge for healthcare professionals. Renal replacement therapy (RRT) use in ICU settings is rising, likely in response to similar trends in AKI, taken together with an ageing population burdened by high prevalence of multi-morbidity and high illness acuity. Numerous features of RRT prescription and delivery are not standardized, nor are they supported from high-quality evidence derived from randomized trials. Despite the publication of rigorous clinical practice guidelines focused on RRT for AKI that are intended to optimize the quality and reliability of RRT in ICU settings, practice patterns and outcomes continue to show significant variability. In this concise review, we aim to summarize new knowledge and recent advances for the provision of RRT for critically ill patients with AKI.

Keywords: Acute kidney injury; Citrate; Fluid overload; Modality; Peritoneal dialysis; Renal replacement therapy.

Publication types

  • Review

MeSH terms

  • Acute Kidney Injury / therapy*
  • Critical Care / standards*
  • Critical Illness / therapy*
  • Humans
  • Practice Guidelines as Topic*
  • Renal Replacement Therapy / standards*
  • Reproducibility of Results