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Renal care 

Renal care
Chapter:
Renal care
Author(s):

Heather Baid

, Fiona Creed

, and Jessica Hargreaves

DOI:
10.1093/med/9780198701071.003.0009
Page of

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date: 21 September 2019

This chapter focuses on acute kidney injury (AKI), which is a major complication in critical care patients both before and after admission. AKI is defined, and the pre-, intra-, and post-renal conditions that cause it are described. The specific disorders associated with AKI are then discussed, including acute glomerulonephritis, hepatorenal syndrome, and rhabdomyolysis, The identification, prevention, and detection of AKI are discussed with reference to the agreed national standards. Management of the patient with AKI is described in relation to the key elements that may be compromised, namely airway and breathing, circulation, fluid balance, and nutrition. The physiological principles and clinical aims of renal replacement therapy (RRT) are then presented. Finally, the different types of RRT are described, including continuous venovenous haemofiltration (CVVH), continuous venovenous haemodialysis (CVVHD), continuous venovenous haemodiafiltration (CVVHDF), intermittent haemodialysis (IHD), and slow continuous ultrafiltration (SCUF).

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