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Acute Kidney Injury in Intensive Care: A Role for Backpressure?

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Annual Update in Intensive Care and Emergency Medicine 2013

Part of the book series: Annual Update in Intensive Care and Emergency Medicine ((AUICEM))

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Abstract

Acute kidney injury (AKI) occurs in approximately two-thirds of intensive care unit (ICU) patients [1] and is associated with increased mortality, length of stay and cost [2]. It is, therefore, essential to better understand its pathogenesis, and to prevent its occurrence. Renal hypoperfusion is thought to worsen the kidney function in situations in which the kidney is already being injured. Many experimental and clinical studies have focused on forward pressure determinants to improve mean arterial pressure (MAP) and cardiac output [3, 4]. There is, however, increasing evidence that backpressure (venous pressure) plays an important role when the kidney is under aggression. Indeed, high levels of central venous pressure (CVP) are associated with AKI suggesting that CVP can detect renal congestion. We will further discuss the potential role of renal venous congestion in the relationship between fluid overload and prognosis in critically ill patients.

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Authors and Affiliations

  1. Department of Anesthesiology and Critical Care and SAMU, AP-HP, Lariboisière Hospital, 75475, Paris, France

    J. Bardon, M. Legrand & A. Mebazaa

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  1. J. Bardon
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  2. M. Legrand
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  3. A. Mebazaa
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Correspondence to M. Legrand .

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Editors and Affiliations

  1. Erasme Hospital, Université libre de Bruxelles, Brussels, Belgium

    Jean-Louis Vincent Prof.

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Bardon, J., Legrand, M., Mebazaa, A. (2013). Acute Kidney Injury in Intensive Care: A Role for Backpressure?. In: Vincent, JL. (eds) Annual Update in Intensive Care and Emergency Medicine 2013. Annual Update in Intensive Care and Emergency Medicine. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-35109-9_53

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  • DOI: https://doi.org/10.1007/978-3-642-35109-9_53

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-35108-2

  • Online ISBN: 978-3-642-35109-9

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