Renal Failure in the ACS Patient: Understanding Appropriate Fluid Management and Renal Replacement Therapy

  • Evan G. Wong
  • Catherine L. Weber
  • Miklosh Bala
  • Dan L. Deckelbaum
  • Tarek RazekEmail author
Part of the Hot Topics in Acute Care Surgery and Trauma book series (HTACST)


AKI is increasingly common in the ICU and is associated with significant morbidity and mortality. Several AKI definitions exist using changes in serum creatinine and urine output, although these markers have limitations. In the critically ill patient with AKI, priorities include maintaining adequate renal perfusion, precise fluid management and prevention of further renal injury. There is increasing evidence that balanced crystalloid solutions and avoidance of volume overload, especially in the maintenance and de-resuscitation phases of critical illness, are associated with improved renal and patient outcomes. There is considerable interest in the timing of RRT initiation according to individual patient need or stage of AKI; however at the present time, indications remain at the discretion of the treating physician. There is no compelling evidence to choose one dialysis modality over another, although some evidence exists for continuous therapies in specific scenarios. The right internal jugular vein is the preferred site for vascular access, and, although a majority of surgical patients are dialysed without anticoagulation, citrate is associated with less side effects and improved clearance parameters compared to heparin. There does not appear to be a benefit to increase the dose of continuous therapies above 20–25 mL/kg/h, and this is the recommended minimal delivered dose of dialysis. Looking into the future, specific biomarkers of kidney injury and imaging modalities are being developed with the goal of earlier identification of AKI. In addition, the introduction of AKI care bundles may improve processes of care and patient outcomes in the critically ill patient with AKI.


Renal failure Acute kidney injury Fluid management Renal replacement therapy 


  1. 1.
    Nash K, Hafeez A, Hou S. Hospital-acquired renal insufficiency. Am J Kidney Dis. 2002;39(5):930–6.PubMedGoogle Scholar
  2. 2.
    Hoste EA, Bagshaw SM, Bellomo R, Cely CM, Colman R, Cruz DN, Edipidis K, Forni LG, Gomersall CD, Govil D, et al. Epidemiology of acute kidney injury in critically ill patients: the multinational AKI-EPI study. Intensive Care Med. 2015;41(8):1411–23.PubMedGoogle Scholar
  3. 3.
    Chawla LS, Abell L, Mazhari R, Egan M, Kadambi N, Burke HB, Junker C, Seneff MG, Kimmel PL. Identifying critically ill patients at high risk for developing acute renal failure: a pilot study. Kidney Int. 2005;68(5):2274–80.PubMedGoogle Scholar
  4. 4.
    White LE, Hassoun HT, Bihorac A, Moore LJ, Sailors RM, McKinley BA, Valdivia A, Moore FA. Acute kidney injury is surprisingly common and a powerful predictor of mortality in surgical sepsis. J Trauma Acute Care Surg. 2013;75(3):432–8.PubMedGoogle Scholar
  5. 5.
    Mehta RL, Pascual MT, Soroko S, Savage BR, Himmelfarb J, Ikizler TA, Paganini EP, Chertow GM, Program to Improve Care in Acute Renal Disease. Spectrum of acute renal failure in the intensive care unit: the PICARD experience. Kidney Int. 2004;66(4):1613–21.PubMedGoogle Scholar
  6. 6.
    Bellomo R, Ronco C, Mehta RL, Asfar P, Boisrame-Helms J, Darmon M, Diehl JL, Duranteau J, Hoste EAJ, Olivier JB, et al. Acute kidney injury in the ICU: from injury to recovery: reports from the 5th Paris International Conference. Ann Intensive Care. 2017;7(1):49.PubMedPubMedCentralGoogle Scholar
  7. 7.
    Coca SG, Peixoto AJ, Garg AX, Krumholz HM, Parikh CR. The prognostic importance of a small acute decrement in kidney function in hospitalized patients: a systematic review and meta-analysis. Am J Kidney Dis. 2007;50(5):712–20.PubMedGoogle Scholar
  8. 8.
    Chertow GM, Christiansen CL, Cleary PD, Munro C, Lazarus JM. Prognostic stratification in critically ill patients with acute renal failure requiring dialysis. Arch Intern Med. 1995;155(14):1505–11.PubMedGoogle Scholar
  9. 9.
    Chertow GM, Burdick E, Honour M, Bonventre JV, Bates DW. Acute kidney injury, mortality, length of stay, and costs in hospitalized patients. J Am Soc Nephrol. 2005;16(11):3365–70.PubMedGoogle Scholar
  10. 10.
    Kerr M, Bedford M, Matthews B, O’Donoghue D. The economic impact of acute kidney injury in England. Nephrol Dial Transplant. 2014;29(7):1362–8.PubMedGoogle Scholar
  11. 11.
    Schiffl H, Lang SM, Fischer R. Long-term outcomes of survivors of ICU acute kidney injury requiring renal replacement therapy: a 10-year prospective cohort study. Clin Kidney J. 2012;5(4):297–302.PubMedPubMedCentralGoogle Scholar
  12. 12.
    Bagshaw SM, Laupland KB, Doig CJ, Mortis G, Fick GH, Mucenski M, Godinez-Luna T, Svenson LW, Rosenal T. Prognosis for long-term survival and renal recovery in critically ill patients with severe acute renal failure: a population-based study. Crit Care. 2005;9(6):R700–9.PubMedPubMedCentralGoogle Scholar
  13. 13.
    Thakar CV, Christianson A, Himmelfarb J, Leonard AC. Acute kidney injury episodes and chronic kidney disease risk in diabetes mellitus. Clin J Am Soc Nephrol. 2011;6(11):2567–72.PubMedPubMedCentralGoogle Scholar
  14. 14.
    Belayev LY, Palevsky PM. The link between acute kidney injury and chronic kidney disease. Curr Opin Nephrol Hypertens. 2014;23(2):149–54.PubMedPubMedCentralGoogle Scholar
  15. 15.
    Wald R, Quinn RR, Luo J, Li P, Scales DC, Mamdani MM, Ray JG, University of Toronto Acute Kidney Injury Research Group. Chronic dialysis and death among survivors of acute kidney injury requiring dialysis. JAMA. 2009;302(11):1179–85.PubMedGoogle Scholar
  16. 16.
    Bihorac A, Delano MJ, Schold JD, Lopez MC, Nathens AB, Maier RV, Layon AJ, Baker HV, Moldawer LL. Incidence, clinical predictors, genomics, and outcome of acute kidney injury among trauma patients. Ann Surg. 2010;252(1):158–65.PubMedPubMedCentralGoogle Scholar
  17. 17.
    American College of Surgeons. National surgical quality improvement program. 2013.Google Scholar
  18. 18.
    Bihorac A, Brennan M, Ozrazgat-Baslanti T, Bozorgmehri S, Efron PA, Moore FA, Segal MS, Hobson CE. National surgical quality improvement program underestimates the risk associated with mild and moderate postoperative acute kidney injury. Crit Care Med. 2013;41(11):2570–83.PubMedGoogle Scholar
  19. 19.
    Mohmand H, Goldfarb S. Renal dysfunction associated with intra-abdominal hypertension and the abdominal compartment syndrome. J Am Soc Nephrol. 2011;22(4):615–21.PubMedPubMedCentralGoogle Scholar
  20. 20.
    Mehta RL, Kellum JA, Shah SV, Molitoris BA, Ronco C, Warnock DG, Levin A, Acute Kidney Injury Network. Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury. Crit Care. 2007;11(2):R31.PubMedPubMedCentralGoogle Scholar
  21. 21.
    Thomas ME, Blaine C, Dawnay A, Devonald MA, Ftouh S, Laing C, Latchem S, Lewington A, Milford DV, Ostermann M. The definition of acute kidney injury and its use in practice. Kidney Int. 2015;87(1):62–73.PubMedGoogle Scholar
  22. 22.
    Bellomo R, Ronco C, Kellum JA, Mehta RL, Palevsky P, Workgroup A. Acute renal failure - definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group. Crit Care. 2004;8(4):R204–12.PubMedPubMedCentralGoogle Scholar
  23. 23.
    Khwaja A. KDIGO clinical practice guidelines for acute kidney injury. Nephron Clin Pract. 2012;120(4):C179–84.PubMedGoogle Scholar
  24. 24.
    Uchino S, Bellomo R, Goldsmith D, Bates S, Ronco C. An assessment of the RIFLE criteria for acute renal failure in hospitalized patients. Crit Care Med. 2006;34(7):1913–7.PubMedGoogle Scholar
  25. 25.
    Ostermann M, Chang RWS. Acute kidney injury in the intensive care unit according to RIFLE. Crit Care Med. 2007;35(8):1837–43.PubMedGoogle Scholar
  26. 26.
    Bagshaw SM, George C, Bellomo R, ANZICS Database Management Committe. A comparison of the RIFLE and AKIN criteria for acute kidney injury in critically ill patients. Nephrol Dial Transplant. 2008;23(5):1569–74.PubMedGoogle Scholar
  27. 27.
    Lopes JA, Fernandes P, Jorge S, Goncalves S, Alvarez A, Costa e Silva Z, Franca C, Prata MM. Acute kidney injury in intensive care unit patients: a comparison between the RIFLE and the Acute Kidney Injury Network classifications. Crit Care. 2008;12(4):R110.PubMedPubMedCentralGoogle Scholar
  28. 28.
    Dennen P, Parikh CR. Biomarkers of acute kidney injury: can we replace serum creatinine? Clin Nephrol. 2007;68(5):269–78.PubMedGoogle Scholar
  29. 29.
    Ostermann M, Joannidis M. Acute kidney injury 2016: diagnosis and diagnostic workup. Crit Care. 2016;20(1):299.PubMedPubMedCentralGoogle Scholar
  30. 30.
    Bragadottir G, Redfors B, Ricksten SE. Assessing glomerular filtration rate (GFR) in critically ill patients with acute kidney injury--true GFR versus urinary creatinine clearance and estimating equations. Crit Care. 2013;17(3):R108.PubMedPubMedCentralGoogle Scholar
  31. 31.
    Dennen P, Douglas IS, Anderson R. Acute kidney injury in the intensive care unit: an update and primer for the intensivist. Crit Care Med. 2010;38(1):261–75.PubMedGoogle Scholar
  32. 32.
    Zhou HY, Chen TW, Zhang XM. Functional magnetic resonance imaging in acute kidney injury: present status. Biomed Res Int. 2016;2016:2027370.PubMedPubMedCentralGoogle Scholar
  33. 33.
    Cecconi M, Hofer C, Teboul JL, Pettila V, Wilkman E, Molnar Z, Della Rocca G, Aldecoa C, Artigas A, Jog S, et al. Fluid challenges in intensive care: the FENICE study: a global inception cohort study. Intensive Care Med. 2015;41(9):1529–37.PubMedPubMedCentralGoogle Scholar
  34. 34.
    Himmelfarb J, Joannidis M, Molitoris B, Schietz M, Okusa MD, Warnock D, Laghi F, Goldstein SL, Prielipp R, Parikh CR, et al. Evaluation and initial management of acute kidney injury. Clin J Am Soc Nephrol. 2008;3(4):962–7.PubMedPubMedCentralGoogle Scholar
  35. 35.
    Raimundo M, Crichton S, Martin JR, Syed Y, Varrier M, Wyncoll D, Ostermann M. Increased fluid administration after early acute kidney injury is associated with less renal recovery. Shock. 2015;44(5):431–7.PubMedGoogle Scholar
  36. 36.
    Vincent JL, De Backer D. Circulatory shock. N Engl J Med. 2013;369(18):1726–34.PubMedGoogle Scholar
  37. 37.
    Hoste EA, Maitland K, Brudney CS, Mehta R, Vincent JL, Yates D, Kellum JA, Mythen MG, Shaw AD, ADQI XII Investigators Group. Four phases of intravenous fluid therapy: a conceptual model. Br J Anaesth. 2014;113(5):740–7.PubMedGoogle Scholar
  38. 38.
    Joannidis M, Druml W, Forni LG, Groeneveld ABJ, Honore PM, Hoste E, Ostermann M, Oudemans-van Straaten HM, Schetz M. Prevention of acute kidney injury and protection of renal function in the intensive care unit: update 2017: Expert opinion of the Working Group on Prevention, AKI section, European Society of Intensive Care Medicine. Intensive Care Med. 2017;43(6):730–49.PubMedPubMedCentralGoogle Scholar
  39. 39.
    Asfar P, Meziani F, Hamel JF, Grelon F, Megarbane B, Anguel N, Mira JP, Dequin PF, Gergaud S, Weiss N, et al. High versus low blood-pressure target in patients with septic shock. N Engl J Med. 2014;370(17):1583–93.PubMedGoogle Scholar
  40. 40.
    Lamontagne F, Day AG, Meade MO, Cook DJ, Guyatt GH, Hylands M, Radermacher P, Chretien JM, Beaudoin N, Hebert P, et al. Pooled analysis of higher versus lower blood pressure targets for vasopressor therapy septic and vasodilatory shock. Intensive Care Med. 2018;44(1):12–21.PubMedGoogle Scholar
  41. 41.
    De Backer D, Biston P, Devriendt J, Madl C, Chochrad D, Aldecoa C, Brasseur A, Defrance P, Gottignies P, Vincent JL, et al. Comparison of dopamine and norepinephrine in the treatment of shock. N Engl J Med. 2010;362(9):779–89.PubMedGoogle Scholar
  42. 42.
    Hajjar LA, Vincent JL, Barbosa Gomes Galas FR, Rhodes A, Landoni G, Osawa EA, Melo RR, Sundin MR, Grande SM, Gaiotto FA, et al. Vasopressin versus norepinephrine in patients with vasoplegic shock after cardiac surgery: the VANCS randomized controlled trial. Anesthesiology. 2017;126(1):85–93.PubMedGoogle Scholar
  43. 43.
    Tumlin JA, Murugan R, Deane AM, Ostermann M, Busse LW, Ham KR, Kashani K, Szerlip HM, Prowle JR, Bihorac A, et al. Outcomes in patients with vasodilatory shock and renal replacement therapy treated with intravenous angiotensin II. Crit Care Med. 2018;46:949.PubMedPubMedCentralGoogle Scholar
  44. 44.
    Friedrich JO, Adhikari N, Herridge MS, Beyene J. Meta-analysis: low-dose dopamine increases urine output but does not prevent renal dysfunction or death. Ann Intern Med. 2005;142(7):510–24.PubMedGoogle Scholar
  45. 45.
    Kellum JA, Decker JM. Use of dopamine in acute renal failure: a meta-analysis. Crit Care Med. 2001;29(8):1526–31.PubMedGoogle Scholar
  46. 46.
    Bove T, Zangrillo A, Guarracino F, Alvaro G, Persi B, Maglioni E, Galdieri N, Comis M, Caramelli F, Pasero DC, et al. Effect of fenoldopam on use of renal replacement therapy among patients with acute kidney injury after cardiac surgery: a randomized clinical trial. JAMA. 2014;312(21):2244–53.PubMedGoogle Scholar
  47. 47.
    Orbegozo Cortes D, Gamarano Barros T, Njimi H, Vincent JL. Crystalloids versus colloids: exploring differences in fluid requirements by systematic review and meta-regression. Anesth Analg. 2015;120(2):389–402.PubMedGoogle Scholar
  48. 48.
    Finfer S, Bellomo R, Boyce N, French J, Myburgh J, Norton R, Norton R, French J, Bellomo R, Finfer S, et al. A comparison of albumin and saline for fluid resuscitation in the intensive care unit. N Engl J Med. 2004;350(22):2247–56.PubMedGoogle Scholar
  49. 49.
    Wiedermann C. Systematic review of randomized clinical trials on the use of hydroxyethyl starch for fluid management in sepsis. BMC Emerg Med. 2008;8:1.PubMedPubMedCentralGoogle Scholar
  50. 50.
    Serpa Neto A, Veelo DP, Peireira VG, de Assuncao MS, Manetta JA, Esposito DC, Schultz MJ. Fluid resuscitation with hydroxyethyl starches in patients with sepsis is associated with an increased incidence of acute kidney injury and use of renal replacement therapy: a systematic review and meta-analysis of the literature. J Crit Care. 2014;29(1):185.e181–7.Google Scholar
  51. 51.
    Moeller C, Fleischmann C, Thomas-Rueddel D, Vlasakov V, Rochwerg B, Theurer P, Gattinoni L, Reinhart K, Hartog CS. How safe is gelatin? A systematic review and meta-analysis of gelatin-containing plasma expanders vs crystalloids and albumin. J Crit Care. 2016;35:75–83.PubMedGoogle Scholar
  52. 52.
    Young P, Bailey M, Beasley R, Henderson S, Mackle D, McArthur C, McGuinness S, Mehrtens J, Myburgh J, Psirides A, et al. Effect of a buffered crystalloid solution vs saline on acute kidney injury among patients in the intensive care unit: the SPLIT randomized clinical trial. JAMA. 2015;314(16):1701–10.PubMedGoogle Scholar
  53. 53.
    Serpa Neto A, Martin Loeches I, Klanderman RB, Freitas Silva R, Gama de Abreu M, Pelosi P, Schultz MJ, PROVE Network Investigators. Balanced versus isotonic saline resuscitation-a systematic review and meta-analysis of randomized controlled trials in operation rooms and intensive care units. Ann Transl Med. 2017;5(16):323.PubMedPubMedCentralGoogle Scholar
  54. 54.
    Semler MW, Wanderer JP, Ehrenfeld JM, Stollings JL, Self WH, Siew ED, Wang L, Byrne DW, Shaw AD, Bernard GR, et al. Balanced crystalloids versus saline in the intensive care unit. The SALT randomized trial. Am J Respir Crit Care Med. 2017;195(10):1362–72.PubMedPubMedCentralGoogle Scholar
  55. 55.
    Semler MW, Self WH, Wanderer JP, Ehrenfeld JM, Wang L, Byrne DW, Stollings JL, Kumar AB, Hughes CG, Hernandez A, et al. Balanced crystalloids versus saline in critically ill adults. N Engl J Med. 2018;378(9):829–39.PubMedPubMedCentralGoogle Scholar
  56. 56.
    KDIGO clinical practice guideline for acute kidney injury.
  57. 57.
    Payen D, de Pont AC, Sakr Y, Spies C, Reinhart K, Vincent JL, Sepsis Occurrence in Acutely Ill Patients (SOAP) Investigators. A positive fluid balance is associated with a worse outcome in patients with acute renal failure. Crit Care. 2008;12(3):R74.PubMedPubMedCentralGoogle Scholar
  58. 58.
    Heung M, Wolfgram DF, Kommareddi M, Hu Y, Song PX, Ojo AO. Fluid overload at initiation of renal replacement therapy is associated with lack of renal recovery in patients with acute kidney injury. Nephrol Dial Transplant. 2012;27(3):956–61.PubMedGoogle Scholar
  59. 59.
    Bouchard J, Soroko SB, Chertow GM, Himmelfarb J, Ikizler TA, Paganini EP, Mehta RL, Program to Improve Care in Acute Renal Disease (PICARD) Study Group. Fluid accumulation, survival and recovery of kidney function in critically ill patients with acute kidney injury. Kidney Int. 2009;76(4):422–7.PubMedGoogle Scholar
  60. 60.
    Grams ME, Estrella MM, Coresh J, Brower RG, Liu KD, National Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome Network. Fluid balance, diuretic use, and mortality in acute kidney injury. Clin J Am Soc Nephrol. 2011;6(5):966–73.PubMedPubMedCentralGoogle Scholar
  61. 61.
    Kim IY, Kim JH, Lee DW, Lee SB, Rhee H, Seong EY, Kwak IS, Song SH. Fluid overload and survival in critically ill patients with acute kidney injury receiving continuous renal replacement therapy. PLoS One. 2017;12(2):e0172137.PubMedPubMedCentralGoogle Scholar
  62. 62.
    Hjortrup PB, Haase N, Bundgaard H, Thomsen SL, Winding R, Pettila V, Aaen A, Lodahl D, Berthelsen RE, Christensen H, et al. Restricting volumes of resuscitation fluid in adults with septic shock after initial management: the CLASSIC randomised, parallel-group, multicentre feasibility trial. Intensive Care Med. 2016;42(11):1695–705.PubMedGoogle Scholar
  63. 63.
    National Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome (ARDS) Clinical Trials Network, Wiedemann HP, Wheeler AP, Bernard GR, Thompson BT, Hayden D, deBoisblanc B, Connors AF Jr, Hite RD, et al. Comparison of two fluid-management strategies in acute lung injury. N Engl J Med. 2006;354(24):2564–75.Google Scholar
  64. 64.
    Ho KM, Sheridan D. Meta-analysis of frusemide to prevent or treat acute renal failure. Br Med J. 2006;333(7565):420–3.Google Scholar
  65. 65.
    Bagshaw SM, Delaney A, Haase M, Ghali WA, Bellomo R. Loop diuretics in the management of acute renal failure: a systematic review and meta-analysis. Crit Care Resusc. 2007;9(1):60–8.PubMedGoogle Scholar
  66. 66.
    Mehta RL, Pascual MT, Soroko S, Chertow GM, PICARD Study Group. Diuretics, mortality, and nonrecovery of renal function in acute renal. JAMA. 2002;288(20):2547–53.PubMedGoogle Scholar
  67. 67.
    Venkataram R, Kellum JA. The role of diuretic agents in the management of acute renal failure. In: Ronco C, Bellomo R, LaGreca G, editors. Blood purification in intensive care, vol. 132; 2001. p. 158–70.Google Scholar
  68. 68.
    Chawla LS, Davison DL, Brasha-Mitchell E, Koyner JL, Arthur JM, Shaw AD, Tumlin JA, Trevino SA, Kimmel PL, Seneff MG. Development and standardization of a furosemide stress test to predict the severity of acute kidney injury. Crit Care. 2013;17(5):R207.PubMedPubMedCentralGoogle Scholar
  69. 69.
    Schetz M, Vanhorebeek I, Wouters PJ, Wilmer A, van den Berghe G. Tight blood glucose control is renoprotective in critically ill patients. J Am Soc Nephrol. 2008;19(3):571–8.PubMedPubMedCentralGoogle Scholar
  70. 70.
    Van den Berghe G, Wilmer A, Hermans G, Meersseman W, Wouters PJ, Milants I, Van Wijngaerden E, Bobbaers H, Bouillon R. Intensive insulin therapy in the medical ICU. N Engl J Med. 2006;354(5):449–61.PubMedGoogle Scholar
  71. 71.
    Van den Berghe G, Wouters P, Weekers F, Verwaest C, Bruyninckx F, Schetz M, Vlasselaers D, Ferdinande P, Lauwers P, Bouillon R. Intensive insulin therapy in critically ill patients. N Engl J Med. 2001;345(19):1359–67.PubMedGoogle Scholar
  72. 72.
    Druml WF. Nutritional management of acute renal failure. J Ren Nutr. 2005;15(1):63–70.PubMedGoogle Scholar
  73. 73.
    Fiaccadori E, Maggiore U, Cabassi A, Morabito S, Castellano G, Regolisti G. Nutritional evaluation and management of AKI patients. J Ren Nutr. 2013;23(3):255–8.PubMedGoogle Scholar
  74. 74.
    Ehrmann S, Quartin A, Hobbs BP, Robert-Edan V, Cely C, Bell C, Lyons G, Pham T, Schein R, Geng Y, et al. Contrast-associated acute kidney injury in the critically ill: systematic review and Bayesian meta-analysis. Intensive Care Med. 2017;43(6):785–94.PubMedGoogle Scholar
  75. 75.
    Hinson JS, Ehmann MR, Fine DM, Fishman EK, Toerper MF, Rothman RE, Klein EY. Risk of acute kidney injury after intravenous contrast media administration. Ann Emerg Med. 2017;69(5):577–86. e574PubMedGoogle Scholar
  76. 76.
    McDonald JS, McDonald RJ, Williamson EE, Kallmes DF, Kashani K. Post-contrast acute kidney injury in intensive care unit patients: a propensity score-adjusted study. Intensive Care Med. 2017;43(6):774–84.PubMedGoogle Scholar
  77. 77.
    Barrett BJ, Carlisle EJ. Metaanalysis of the relative nephrotoxicity of high- and low-osmolality iodinated contrast media. Radiology. 1993;188(1):171–8.PubMedGoogle Scholar
  78. 78.
    Cruz DN, Perazella MA, Bellomo R, Corradi V, de Cal M, Kuang D, Ocampo C, Nalesso F, Ronco C. Extracorporeal blood purification therapies for prevention of radiocontrast-induced nephropathy: a systematic review. Am J Kidney Dis. 2006;48(3):361–71.PubMedGoogle Scholar
  79. 79.
    Selby NM, Kolhe NV. Care bundles for acute kidney injury: do they work? Nephron. 2016;134(3):195–9.PubMedGoogle Scholar
  80. 80.
    Forde C, McCaughan J, Leonard N. Acute kidney injury: it’s as easy as ABCDE. BMJ Qual Improv Rep. 2012;1(1):u200370.w326.PubMedPubMedCentralGoogle Scholar
  81. 81.
    Tsui A, Rajani C, Doshi R, De Wolff J, Tennant R, Duncan N, Penn H. Improving recognition and management of acute kidney injury. Acute Med. 2014;13(3):108–12.PubMedGoogle Scholar
  82. 82.
    Joslin J, Wilson H, Zubli D, Gauge N, Kinirons M, Hopper A, Pile T, Ostermann M. Recognition and management of acute kidney injury in hospitalised patients can be partially improved with the use of a care bundle. Clin Med (Lond). 2015;15(5):431–6.Google Scholar
  83. 83.
    Selby NM, Crowley L, Fluck RJ, McIntyre CW, Monaghan J, Lawson N, Kolhe NV. Use of electronic results reporting to diagnose and monitor AKI in hospitalized patients. Clin J Am Soc Nephrol. 2012;7(4):533–40.PubMedGoogle Scholar
  84. 84.
    Kolhe NV, Staples D, Reilly T, Merrison D, McIntyre CW, Fluck RJ, Selby NM, Taal MW. Impact of compliance with a care bundle on acute kidney injury outcomes: a prospective observational Study. PLoS One. 2015;10(7):e0132279.PubMedPubMedCentralGoogle Scholar
  85. 85.
    Kolhe NV, Reilly T, Leung J, Fluck RJ, Swinscoe KE, Selby NM, Taal MW. A simple care bundle for use in acute kidney injury: a propensity score-matched cohort study. Nephrol Dial Transplant. 2016;31(11):1846–54.PubMedGoogle Scholar
  86. 86.
    Ricci Z, Ronco C, D’Amico G, De Felice R, Rossi S, Bolgan I, Bonello M, Zamperetti N, Petras D, Salvatori G, et al. Practice patterns in the management of acute renal failure in the critically ill patient: an international survey. Nephrol Dial Transplant. 2006;21(3):690–6.PubMedGoogle Scholar
  87. 87.
    RENAL Study Investigators. Renal replacement therapy for acute kidney injury in Australian and New Zealand intensive care units: a practice survey. Crit Care Resusc. 2008;10(3):225–30.Google Scholar
  88. 88.
    Mehta RL. Indications for dialysis in the ICU: renal replacement vs. renal support. Blood Purif. 2001;19(2):227–32.PubMedGoogle Scholar
  89. 89.
    Ostermann M, Joannidis M, Pani A, Floris M, De Rosa S, Kellum JA, Ronco C, 17th Acute Disease Quality Initiative (ADQI) Consensus Group. Patient selection and timing of continuous renal replacement therapy. Blood Purif. 2016;42(3):224–37.PubMedGoogle Scholar
  90. 90.
    Bhatt GC, Das RR. Early versus late initiation of renal replacement therapy in patients with acute kidney injury-a systematic review & meta-analysis of randomized controlled trials. BMC Nephrol. 2017;18(1):78.PubMedPubMedCentralGoogle Scholar
  91. 91.
    Wierstra BT, Kadri S, Alomar S, Burbano X, Barrisford GW, Kao RL. The impact of “early” versus “late” initiation of renal replacement therapy in critical care patients with acute kidney injury: a systematic review and evidence synthesis. Crit Care. 2016;20(1):122.PubMedPubMedCentralGoogle Scholar
  92. 92.
    Gaudry S, Hajage D, Schortgen F, Martin-Lefevre L, Pons B, Boulet E, Boyer A, Chevrel G, Lerolle N, Carpentier D, et al. Initiation strategies for renal-replacement therapy in the intensive care unit. N Engl J Med. 2016;375(2):122–33.PubMedGoogle Scholar
  93. 93.
    Zarbock A, Kellum JA, Schmidt C, Van Aken H, Wempe C, Pavenstadt H, Boanta A, Gerss J, Meersch M. Effect of early vs delayed initiation of renal replacement therapy on mortality in critically ill patients with acute kidney injury: the ELAIN randomized clinical trial. JAMA. 2016;315(20):2190–9.PubMedGoogle Scholar
  94. 94.
    Meersch M, Kullmar M, Schmidt C, Gerss J, Weinhage T, Margraf A, Ermert T, Kellum JA, Zarbock A. Long-term clinical outcomes after early initiation of RRT in critically ill patients with AKI. J Am Soc Nephrol. 2018;29(3):1011–9.PubMedGoogle Scholar
  95. 95.
    Udani SM, Koyner JL, Murray PT. Renal replacement therapy in the intensive care unit. In: Hall JB, Schmidt GA, Kress JP, editors. Principles of critical care. New York: McGraw Hill Education; 2015.Google Scholar
  96. 96.
    Vinsonneau C, Camus C, Combes A, Costa de Beauregard MA, Klouche K, Boulain T, Pallot J-L, Chiche J-D, Taupin P, Landais P, et al. Continuous venovenous haemodiafiltration versus intermittent haemodialysis for acute renal failure in patients with multiple-organ dysfunction syndrome: a multicentre randomised trial. Lancet. 2006;368(9533):379–85.PubMedGoogle Scholar
  97. 97.
    Lins RL, Elseviers MM, Van der Niepen P, Hoste E, Malbrain ML, Damas P, Devriendt J, Investigators S. Intermittent versus continuous renal replacement therapy for acute kidney injury patients admitted to the intensive care unit: results of a randomized clinical trial. Nephrol Dial Transplant. 2009;24(2):512–8.PubMedGoogle Scholar
  98. 98.
    Pannu N, Klarenbach S, Wiebe N, Manns B, Tonelli M, Alberta Kidney Disease Network. Renal replacement therapy in patients with acute renal failure - a systematic review. JAMA. 2008;299(7):793–805.PubMedGoogle Scholar
  99. 99.
    Schneider AG, Bellomo R, Bagshaw SM, Glassford NJ, Lo S, Jun M, Cass A, Gallagher M. Choice of renal replacement therapy modality and dialysis dependence after acute kidney injury: a systematic review and meta-analysis. Intensive Care Med. 2013;39(6):987–97.PubMedGoogle Scholar
  100. 100.
    Friedrich JO, Wald R, Bagshaw SM, Burns KE, Adhikari NK. Hemofiltration compared to hemodialysis for acute kidney injury: systematic review and meta-analysis. Crit Care. 2012;16(4):R146.PubMedPubMedCentralGoogle Scholar
  101. 101.
    Morgan D, Ho K, Murray C, Davies H, Louw J. A randomized trial of catheters of different lengths to achieve right atrium versus superior vena cava placement for continuous renal replacement therapy. Am J Kidney Dis. 2012;60(2):272–9.PubMedGoogle Scholar
  102. 102.
    Parienti JJ, Thirion M, Megarbane B, Souweine B, Ouchikhe A, Polito A, Forel JM, Marque S, Misset B, Airapetian N, et al. Femoral vs jugular venous catheterization and risk of nosocomial events in adults requiring acute renal replacement therapy: a randomized controlled trial. JAMA. 2008;299(20):2413–22.PubMedGoogle Scholar
  103. 103.
    Parienti JJ, Megarbane B, Fischer MO, Lautrette A, Gazui N, Marin N, Hanouz JL, Ramakers M, Daubin C, Mira JP, et al. 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. 2010;38(4):1118–25.PubMedGoogle Scholar
  104. 104.
    Parienti JJ, Dugue AE, Daurel C, Mira JP, Megarbane B, Mermel LA, Daubin C, du Cheyron D, Members of the Cathedia Study Group. Continuous renal replacement therapy may increase the risk of catheter infection. Clin J Am Soc Nephrol. 2010;5(8):1489–96.PubMedPubMedCentralGoogle Scholar
  105. 105.
    Dugue AE, Levesque SP, Fischer MO, Souweine B, Mira JP, Megarbane B, Daubin C, du Cheyron D, Parienti JJ, Cathedia Study Group. Vascular access sites for acute renal replacement in intensive care units. Clin J Am Soc Nephrol. 2012;7(1):70–7.PubMedGoogle Scholar
  106. 106.
    Clark EG, Barsuk JH. Temporary hemodialysis catheters: recent advances. Kidney Int. 2014;86(5):888–95.PubMedPubMedCentralGoogle Scholar
  107. 107.
    Ronco C, Bellomo R, Homel P, Brendolan A, Dan M, Piccinni P, La Greca G. Effects of different doses in continuous veno-venous haemofiltration on outcomes of acute renal failure: a prospective randomised trial. Lancet. 2000;356(9223):26–30.PubMedGoogle Scholar
  108. 108.
    Palevsky PM, Zhang JH, O’Connor TZ, Chertow GM, Crowley ST, Choudhury D, Finkel K, Kellum JA, Paganini E, Schein RMH, et al. Intensity of renal support in critically ill patients with acute kidney injury. N Engl J Med. 2008;359(1):7–20.PubMedGoogle Scholar
  109. 109.
    Bellomo R, Cass A, Norton R, Gallagher M, Lo S, Su S, Cole L, Finfer S, McArthur C, McGuinness S, et al. Intensity of continuous renal-replacement therapy in critically ill patients. N Engl J Med. 2009;361(17):1627–38.PubMedGoogle Scholar
  110. 110.
    Joannidis M, Oudemans-van Straaten HM. Clinical review: patency of the circuit in continuous renal replacement therapy. Crit Care. 2007;11(4):218.PubMedPubMedCentralGoogle Scholar
  111. 111.
    Oudemans-van Straaten HM, Kellum JA, Bellomo R. Clinical review: anticoagulation for continuous renal replacement therapy - heparin or citrate? Crit Care. 2011;15(1):202.PubMedPubMedCentralGoogle Scholar
  112. 112.
  113. 113.
    Bai M, Zhou M, He L, Ma F, Li Y, Yu Y, Wang P, Li L, Jing R, Zhao L, et al. Citrate versus heparin anticoagulation for continuous renal replacement therapy: an updated meta-analysis of RCTs. Intensive Care Med. 2015;41(12):2098–110.PubMedGoogle Scholar
  114. 114.
    Schortgen F, Soubrier N, Delclaux C, Thuong M, Girou E, Brun-Buisson C, Lemaire F, Brochard L. Hemodynamic tolerance of intermittent hemodialysis in critically ill patients: usefulness of practice guidelines. Am J Respir Crit Care Med. 2000;162(1):197–202.PubMedGoogle Scholar
  115. 115.
    Hoste EA, Dhondt A. Clinical review: use of renal replacement therapies in special groups of ICU patients. Crit Care. 2012;16(1):201.PubMedPubMedCentralGoogle Scholar
  116. 116.
    Davenport A, Will EJ, Davison AM. Early changes in intracranial pressure during haemofiltration treatment in patients with grade 4 hepatic encephalopathy and acute oliguric renal failure. Nephrol Dial Transplant. 1990;5(3):192–8.PubMedGoogle Scholar
  117. 117.
    Davenport A, Will EJ, Davidson AM. Improved cardiovascular stability during continuous modes of renal replacement therapy in critically ill patients with acute hepatic and renal failure. Crit Care Med. 1993;21(3):328–38.PubMedGoogle Scholar
  118. 118.
    Stravitz RT, Kramer AH, Davern T, Shaikh AO, Caldwell SH, Mehta RL, Blei AT, Fontana RJ, McGuire BM, Rossaro L, et al. Intensive care of patients with acute liver failure: recommendations of the U.S. Acute Liver Failure Study Group. Crit Care Med. 2007;35(11):2498–508.PubMedGoogle Scholar
  119. 119.
    Davenport A. Practical guidance for dialyzing a hemodialysis patient following acute brain injury. Hemodial Int. 2008;12(3):307–12.PubMedGoogle Scholar
  120. 120.
    Cole L, Bellomo R, Hart G, Journois D, Davenport P, Tipping P, Ronco C. A phase II randomized, controlled trial of continuous hemofiltration in sepsis. Crit Care Med. 2002;30(1):100–6.PubMedGoogle Scholar
  121. 121.
    Payen D, Mateo J, Cavaillon JM, Fraisse F, Floriot C, Vicaut E, Hemofiltration and Sepsis Group of the Collège National de Réanimation et de Médecine d’Urgence des Hôpitaux extra-Universitaires. Impact of continuous venovenous hemofiltration on organ failure during the early phase of severe sepsis: a randomized controlled trial. Crit Care Med. 2009;37(3):803–10.PubMedGoogle Scholar
  122. 122.
    Joannes-Boyau O, Honore PM, Perez P, Bagshaw SM, Grand H, Canivet JL, Dewitte A, Flamens C, Pujol W, Grandoulier AS, et al. High-volume versus standard-volume haemofiltration for septic shock patients with acute kidney injury (IVOIRE study): a multicentre randomized controlled trial. Intensive Care Med. 2013;39(9):1535–46.PubMedGoogle Scholar
  123. 123.
    Klein DJ, Foster D, Schorr CA, Kazempour K, Walker PM, Dellinger RP. The EUPHRATES trial (Evaluating the Use of Polymyxin B Hemoperfusion in a Randomized controlled trial of Adults Treated for Endotoxemia and Septic shock): study protocol for a randomized controlled trial. Trials. 2014;15:218.PubMedPubMedCentralGoogle Scholar
  124. 124.

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Evan G. Wong
    • 1
  • Catherine L. Weber
    • 2
  • Miklosh Bala
    • 3
  • Dan L. Deckelbaum
    • 1
  • Tarek Razek
    • 1
    Email author
  1. 1.Department of SurgeryMcGill University Health CentreMontrealCanada
  2. 2.Division of NephrologyMcGill University Health CentreMontrealCanada
  3. 3.Department of SurgeryHadassah-Hebrew University Medical CenterJerusalemIsrael

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