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Renal disorders 

Renal disorders
Renal disorders

Carl Waldmann

, Neil Soni

, and Andrew Rhodes

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date: 09 May 2021

Prevention of acute renal failure 312

Diagnosis of acute renal failure 314

Acute kidney injury (AKI) often complicates the course of critical illness and was previously considered as a marker rather than a cause of adverse outcomes, it is independently associated with an increase in both morbidity and mortality. The major causes of AKI in the ICU include hypoperfusion, sepsis and direct nephrotoxicity, with the common aetiology believed to be a change in intrarenal haemodynamics with resultant acute tubular dysfunction and oxidant stress. Treatment of established acute renal failure in the ICU entails the use of RRT by means of various modalities, although this therapy itself carries an inherent morbidity and risk. Therefore, preventing or minimizing renal injury should confer a benefit to patients. Consequently, several pharmacological interventions have been tried to treat AKI. These interventions can be separated into measures influencing renal perfusion and measures modulating intrarenal pathophysiology....

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