Skip to main content
Log in

Nierenersatztherapie bei akutem Nierenversagen

Kidney replacement therapy for acute kidney injury

  • Leitthema
  • Published:
Die Nephrologie Aims and scope

Zusammenfassung

Etwa jede(r) fünfte stationär aufgenommene Patientin/Patient entwickelt ein akutes Nierenversagen („acute kidney injury“, AKI). Schweres AKI kann eine passagere oder dauerhafte Nierenersatztherapie (NET) notwendig machen. Dieser Übersichtsartikel fasst den aktuellen Stand der verfügbaren Möglichkeiten der NET, Überlegungen zur jeweiligen Indikation und spezifische Aspekte bei der Durchführung im Falle eines AKI zusammen.

Abstract

Approximately one out of five hospitalized patents develops an acute kidney injury (AKI). Severe AKI can necessitate temporary or permanent kidney replacement therapy (KRT). This review article summarizes the current state of available KRT options, considerations on the indications and specific aspects of their use in the case of AKI.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Literatur

  1. Bagshaw SM, Darmon M, Ostermann M et al (2017) Current state of the art for renal replacement therapy in critically ill patients with acute kidney injury. Intensive Care Med 43:841–854

    Article  PubMed  Google Scholar 

  2. Chawla LS, Davison DL, Brasha-Mitchell E et al (2013) Development and standardization of a furosemide stress test to predict the severity of acute kidney injury. Crit Care 17:R207

    Article  PubMed  PubMed Central  Google Scholar 

  3. Chen YT, Pan HC, Hsu CK et al (2023) Performance of urinary C‑C motif chemokine ligand 14 for the prediction of persistent acute kidney injury: a systematic review and meta-analysis. Crit Care 27:318

    Article  PubMed  PubMed Central  Google Scholar 

  4. Crabtree JH, Shrestha BM, Chow KM et al (2019) Creating and maintaining optimal peritoneal dialysis access in the adult patient: 2019 update. Perit Dial Int 39:414–436

    Article  PubMed  Google Scholar 

  5. Cullis B, Al-Hwiesh A, Kilonzo K et al (2021) ISPD guidelines for peritoneal dialysis in acute kidney injury: 2020 update (adults). Perit Dial Int 41:15–31

    Article  PubMed  Google Scholar 

  6. Friedrich JO, Wald R, Bagshaw SM et al (2012) Hemofiltration compared to hemodialysis for acute kidney injury: systematic review and meta-analysis. Crit Care 16:R146

    Article  PubMed  PubMed Central  Google Scholar 

  7. Gaudry S, Grolleau F, Barbar S et al (2022) Continuous renal replacement therapy versus intermittent hemodialysis as first modality for renal replacement therapy in severe acute kidney injury: a secondary analysis of AKIKI and IDEAL-ICU studies. Crit Care 26:93

    Article  PubMed  PubMed Central  Google Scholar 

  8. Hoste EA, Bagshaw SM, Bellomo R et al (2015) Epidemiology of acute kidney injury in critically ill patients: the multinational AKI-EPI study. Intensive Care Med 41:1411–1423

    Article  PubMed  Google Scholar 

  9. Htay H, Johnson DW, Craig JC et al (2021) Urgent-start peritoneal dialysis versus haemodialysis for people with chronic kidney disease. Cochrane Database Syst Rev 1:Cd12899

    PubMed  Google Scholar 

  10. Investigators RRTS, Bellomo R, Cass A et al (2009) Intensity of continuous renal-replacement therapy in critically ill patients. N Engl J Med 361:1627–1638

    Article  Google Scholar 

  11. Investigators S‑A, Canadian Critical Care Trials G, Australian et al (2020) Timing of initiation of renal-replacement therapy in acute kidney injury. N Engl J Med 383:240–251

    Article  Google Scholar 

  12. KDIGO (2012) Clinical practice guideline for acute kidney injury. Kidney Int Suppl 2:1–138

    Google Scholar 

  13. Kelly YP, Waikar SS, Mendu ML (2019) When to stop renal replacement therapy in anticipation of renal recovery in AKI: the need for consensus guidelines. Semin Dial 32:205–209

    Article  PubMed  Google Scholar 

  14. Lewington AJ, Cerdá J, Mehta RL (2013) Raising awareness of acute kidney injury: a global perspective of a silent killer. Kidney Int 84:457–467

    Article  PubMed  PubMed Central  Google Scholar 

  15. Li JH, Cai JH, Wang MJ et al (2023) Early strategy vs. late initiation of renal replacement therapy in adult patients with acute kidney injury: an updated systematic review and meta-analysis of randomized controlled trials. Eur Rev Med Pharmacol Sci 27:6046–6057

    PubMed  Google Scholar 

  16. Mc Causland FR, Asafu-Adjei J, Betensky RA et al (2016) Comparison of urine output among patients treated with more intensive versus less intensive RRT: results from the acute renal failure trial network study. Clin J Am Soc Nephrol 11:1335–1342

    Article  PubMed  PubMed Central  Google Scholar 

  17. Mehta RL, Cerdá J, Burdmann EA et al (2015) International Society of Nephrology’s 0by25 initiative for acute kidney injury (zero preventable deaths by 2025): a human rights case for nephrology. Lancet 385:2616–2643

    Article  PubMed  Google Scholar 

  18. Nash DM, Przech S, Wald R et al (2017) Systematic review and meta-analysis of renal replacement therapy modalities for acute kidney injury in the intensive care unit. J Crit Care 41:138–144

    Article  PubMed  Google Scholar 

  19. Network VNRFT, Palevsky PM, Zhang JH et al (2008) Intensity of renal support in critically ill patients with acute kidney injury. N Engl J Med 359:7–20

    Article  Google Scholar 

  20. Palamaner Subash SG, Kumar AA, Sethi M et al (2015) Efficacy and safety of low molecular weight heparin compared to unfractionated heparin for chronic outpatient hemodialysis in end stage renal disease: systematic review and meta-analysis. PeerJ 3:e835

    Article  Google Scholar 

  21. Parienti JJ, Megarbane B, Fischer MO et al (2010) Catheter dysfunction and dialysis performance according to vascular access among 736 critically ill adults requiring renal replacement therapy: a randomized controlled study. Crit Care Med 38:1118–1125

    Article  PubMed  Google Scholar 

  22. Raina R, Davenport A, Warady B et al (2022) Dialysis disequilibrium syndrome (DDS) in pediatric patients on dialysis: systematic review and clinical practice recommendations. Pediatr Nephrol 37:263–274

    Article  PubMed  Google Scholar 

  23. Rosen SM, O’connor K, Shaldon S (1964) HAEMODIALYSIS DISEQUILIBRIUM. Br Med J 2:672–675

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Slowinski T, Morgera S, Joannidis M et al (2015) Safety and efficacy of regional citrate anticoagulation in continuous venovenous hemodialysis in the presence of liver failure: the Liver Citrate Anticoagulation Threshold (L-CAT) observational study. Crit Care 19:349

    Article  PubMed  PubMed Central  Google Scholar 

  25. Teixeira JP, Neyra JA, Tolwani A (2023) Continuous KRT: a contemporary review. Clin J Am Soc Nephrol 18:256–269

    Article  PubMed  Google Scholar 

  26. Vijayan A, Delos Santos RB, Li T et al (2018) Effect of frequent dialysis on renal recovery: results from the acute renal failure trial network study. Kidney Int 3:456–463

    Google Scholar 

  27. Wald R, Gaudry S, Da Costa BR et al (2023) Initiation of continuous renal replacement therapy versus intermittent hemodialysis in critically ill patients with severe acute kidney injury: a secondary analysis of STARRT-AKI trial. Intensive Care Med 49:1305–1316

    Article  PubMed  Google Scholar 

  28. Zarbock A, Kullmar M, Kindgen-Milles D et al (2020) Effect of Regional Citrate Anticoagulation vs Systemic Heparin Anticoagulation During Continuous Kidney Replacement Therapy on Dialysis Filter Life Span and Mortality Among Critically Ill Patients With Acute Kidney Injury: A Randomized Clinical Trial. JAMA 324:1629–1639

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Alexander Reshetnik.

Ethics declarations

Interessenkonflikt

A. Reshetnik und A. Krüger geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autor/-innen keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

Additional information

Redaktion

Kai-Uwe Eckardt, Berlin

Kirsten de Groot, Offenbach am Main

Kai Schmidt-Ott, Hannover

Hinweis des Verlags

Der Verlag bleibt in Hinblick auf geografische Zuordnungen und Gebietsbezeichnungen in veröffentlichten Karten und Institutsadressen neutral.

figure qr

QR-Code scannen & Beitrag online lesen

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Reshetnik, A., Krüger, A. Nierenersatztherapie bei akutem Nierenversagen. Nephrologie (2024). https://doi.org/10.1007/s11560-024-00716-3

Download citation

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s11560-024-00716-3

Schlüsselwörter

Keywords

Navigation