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Severe acute kidney injury in the intensive care unit: step-to-step management
Mauro Riccardi1,2, Matteo Pagnesi1, Carlo M Lombardi1,2
1Institute of Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Spedali Civili di Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy.
Abstract:
Acute kidney injury (AKI) is a sudden loss of renal function limited to 7 days with increased basal serum creatinine levels and/or decreased urinary production. AKI is a frequent condition in the intensive care unit (ICU) ranging from 13% to 36% in patients hospitalized with acute heart failure, up to 80% in patients with cardiogenic shock (CS). AKI requiring dialysis is also common (5% to 8%) and can exceed 13% in patients with CS. AKI is consistently associated with increased mortality in both the short-term, especially when dialysis is needed, and the long-term. The aim of this review is to provide an update on step-by-step management, from pharmacological treatment to renal replacement therapy, in patients with severe AKI in ICU patients with fluid overload.
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