Issues of Acute Kidney Injury Staging and Management in Sepsis and Critical Illness: A Narrative Review
AbstractAcute kidney injury (AKI) has a high incidence on intensive care units around the world and is a major complication in critically ill patients suffering from sepsis or septic shock. The short- and long-term complications are thereby devastating and impair the quality of life. Especially in terms of AKI staging, the determination of kidney function and the timing of dialytic AKI management outside of life-threatening indications are ongoing matters of debate. Despite several studies, a major problem remains in distinguishing between beneficial and unnecessary “early” or even harmful renal replacement therapy (RRT). The latter might prolong disease course and renal recovery. AKI scores, however, provide an insufficient outcome-predicting ability and the related estimation of kidney function via serum creatinine or blood urea nitrogen (BUN)/urea is not reliable in AKI and critical illness. Kidney independent alterations of creatinine- and BUN/urea-levels further complicate the situation. This review critically assesses the current AKI staging, issues and pitfalls of the determination of kidney function and RRT timing, as well as the potential harm reflected by unnecessary RRT. A better understanding is mandatory to improve future study designs and avoid unnecessary RRT for higher patient safety and lower health care costs. View Full-Text
Scifeed alert for new publicationsNever miss any articles matching your research from any publisher
- Get alerts for new papers matching your research
- Find out the new papers from selected authors
- Updated daily for 49'000+ journals and 6000+ publishers
- Define your Scifeed now
Nusshag, C.; Weigand, M.A.; Zeier, M.; Morath, C.; Brenner, T. Issues of Acute Kidney Injury Staging and Management in Sepsis and Critical Illness: A Narrative Review. Int. J. Mol. Sci. 2017, 18, 1387.
Nusshag C, Weigand MA, Zeier M, Morath C, Brenner T. Issues of Acute Kidney Injury Staging and Management in Sepsis and Critical Illness: A Narrative Review. International Journal of Molecular Sciences. 2017; 18(7):1387.Chicago/Turabian Style
Nusshag, Christian; Weigand, Markus A.; Zeier, Martin; Morath, Christian; Brenner, Thorsten. 2017. "Issues of Acute Kidney Injury Staging and Management in Sepsis and Critical Illness: A Narrative Review." Int. J. Mol. Sci. 18, no. 7: 1387.
Note that from the first issue of 2016, MDPI journals use article numbers instead of page numbers. See further details here.