Renal failure and its treatment |
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| Authors: | Rachael Croft John Moore |
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| Affiliation: | 1. University College London Hospitals NHS Foundation Trust, London, UK;2. St.Richard''s Hospital, Chichester, UK;3. Guy''s and St. Thomas'' Hospitals NHS Foundation Trust, London, UK;4. Princess Alexandra Hospital, Harlow, UK;5. University Hospital of South Manchester NHS Foundation Trust, Wythenshawe, UK;1. Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Conn;2. Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Conn;3. SJTU-Yale Joint Center for Biostatistics, School of Life Science and Biotechnology, Shanghai Jiao Tong University, Shanghai, China;4. Shanghai Engineering Research Center for Big Data in Pediatric Precision Medicine, Shanghai, China;5. Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, Tex;6. iKang Healthcare Group, Inc., Shanghai, China;7. Department of Cardiology, Xinhua Hospital Affiliated with Shanghai Jiao Tong University School of Medicine, Shanghai, China;8. Department of Hypertension at Heart Center, People''s Hospital, Peking University, Beijing, China;9. National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China;10. Department of Biostatistics, School of Public Health, Yale University, New Haven, Conn;11. Center for Biomedical Informatics, Shanghai Children''s Hospital, Shanghai, China;12. Beijing Li-Heng Medical Technologies, Ltd, Beijing, China;13. Department of Health Policy and Management, Yale School of Public Health, New Haven, Conn |
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| Abstract: | Kidney disease can be defined as acute or chronic kidney injury. Acute kidney injury is measured directly via glomerular filtration rate (GFR) and indirectly via urea and electrolyte levels. Acute kidney injury can be classified via the RIFLE criteria.Chronic kidney injury is a progressive and irreversible condition, which is defined as an estimated GFR (eGFR) less than 60 ml/minute/1.73 m2 or where there is evidence of chronic kidney damage (irrespective of eGFR) on at least two occasions more than 3 months apart. As chronic kidney injury progresses there are a number of co-morbidities associated with the disease process, cardiovascular, respiratory and endocrine. These co-morbidities must be considered when anaesthetizing a patient with kidney injury.Renal replacement therapy may be necessary for patients who acutely deteriorate to end-stage renal failure or in those with a slow progression to this point. Haemofiltration or haemodiafiltration may be used in the acute setting and haemodialysis or peritoneal dialysis may be used in cases where the deterioration of renal function takes a more progressive course. |
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