Renal failure and its treatment |
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| Authors: | Iain Gall John Moore |
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| Affiliation: | 1. Department of Veterinary Science and Public Health, Università degli Studi di Milano, 10 via G. Celoria, I-20133 Milan, Italy;2. Department of Health, Animal Sciences and Food Safety, Università degli Studi di Milano, 10 via G. Celoria, I-20133 Milan, Italy;1. Institute of Electronics and Informatics Engineering of Aveiro (IEETA), Departamento de Electrónica, Telecomunicações e Informática, Universidade de Aveiro, Aveiro, Portugal;2. Esthesys Ltd, London, UK;3. Hospital Veterinário do Porto (HVP), Porto, Portugal;4. Research Center for Biosciences & Health Technologies, Universidade Lusófona de Humanidade e Tecnologia, Lisboa, Portugal;5. Rede de quimica e tecnologia (REQUIMTE), Faculdade de farmácia da universidade do porto (FFUP), Porto, Portugal;6. Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAD), Veterinary Sciences Department, University of Trás-os-Montes and Alto Douro (UTAD), Quinta de Prados, 5001-801 Vila Real, Portugal;7. Institute of Molecular and Cell Biology (IBMC), Porto, Rua do Campo Alegre, n° 823, 4150-180 Porto, Portugal;8. Departamento de Ciências e Tecnologia, Universidade Aberta, Delegação do Porto, Portugal;9. Centro de Investigação Clínica em Anestesiologia, Serviço de Anestesiologia, Centro Hospitalar do Porto, Portugal |
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| Abstract: | Impaired renal function is increasingly common amongst hospital patients and is associated with significant morbidity and mortality. There has been a recent shift from traditional methods of assessing the glomerular filtration rate (GFR) towards biochemistry laboratories routinely reporting formulaic estimates of GFR. Knowledge of the treatment of and pathophysiological complications associated with chronic kidney disease are essential for anaesthetists and intensivists to provide safe and effective care to these patients. The term acute kidney injury (AKI) is now preferred to refer to the full spectrum of acute renal failure. The consensus definition and classification of AKI has recently been modified in the light of evidence that small changes in serum creatinine are associated with adverse outcome. The aetiology, identification and management of AKI is reviewed. The number of patients receiving renal replacement therapy (RRT) in the UK is rising, the cost of which already accounts for 2% of the total NHS budget. The various types of RRT used in both end-stage renal failure and AKI are discussed along with some of the controversies associated with their use in critically ill patients. |
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