Video Experimental Relacionado
Updated: Sep 9, 2025
05:34
5/6 Nephrectomy Using Sharp Bipolectomy Via Midline Laparotomy in Rats
Published on: April 4, 2025
838
Ampliar los límites de la terapia de reemplazo renal en pacientes con insuficiencia hepática
Amer A Belal1, Alfonso H Santos2, Abhilash Koratala3
1Division of Nephrology, Hypertension and Renal Transplantation, University of Florida, Gainesville, FL 32610, United States. amer.belal@medicine.ufl.edu.
World journal of critical care medicine
|August 29, 2025
Resumen
La lesión renal aguda (IRA) es común en pacientes con insuficiencia hepática, que a menudo necesitan terapia de reemplazo renal (TRC). Esta revisión detalla el manejo de AKI en la insuficiencia hepática, centrándose en la personalización de KRT para las necesidades únicas del paciente, como los riesgos de sangrado e hiperammonemia.
Área de la Ciencia:
- Nefrología
- Hepatología
- Medicina de cuidados intensivos
Sus antecedentes:
- La lesión renal aguda (IRA) con frecuencia complica la insuficiencia hepática, lo que requiere terapia de reemplazo renal (TRC) en casos graves.
- Los pacientes con insuficiencia hepática presentan desafíos únicos para la KRT debido a la disfunción cardiocircular y las tendencias a sangrar.
Objetivo del estudio:
- Para proporcionar una visión general de AKI en la insuficiencia hepática.
- Para discutir la fisiopatología del síndrome hepatorenal, incluyendo la afectación cardíaca.
- Describir las estrategias actuales de TCC y las indicaciones emergentes para esta población.
Principales métodos:
- Revisión de la literatura existente sobre el AKI en la insuficiencia hepática.
- Discusión de la fisiopatología del síndrome hepatorenal.
- Análisis de los principios y adaptaciones de la KRT para pacientes con insuficiencia hepática.
Principales resultados:
- AKI es una complicación significativa de la insuficiencia hepática que requiere KRT adaptado.
- Se prefiere la terapia de reemplazo renal continua y la anticoagulación regional para la KRT en la insuficiencia hepática.
- La hiperammonemia es una indicación emergente no renal para la TRK en esta cohorte.
Conclusiones:
- El manejo de AKI en la insuficiencia hepática requiere enfoques especializados de KRT.
- La comprensión del síndrome hepatorenal y los factores específicos del paciente es crucial para una TCR eficaz.
- KRT ofrece beneficios más allá del apoyo renal, incluyendo el manejo de la hiperammonemia en la insuficiencia hepática.
Videos de Conceptos Relacionados
01:28Kidney Transplant I: Introduction
60
A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
60
01:26Kidney Transplant II: Surgical Procedure
75
Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
75
01:16Kidney Transplant III: Nursing Management
80
Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
80
01:20Acute Kidney Injury V: Interprofessional Care
44
Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
44
01:28Chronic Kidney Disease III: Interprofessional Care
77
Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
77
01:30Continuous Renal Replacement Therapy
129
Continuous Renal Replacement Therapy, also known as CRRT, is a procedural treatment for acute kidney injury (AKI) that gradually removes uremic toxins and fluids while maintaining acid-base balance and stabilizing electrolytes. It is particularly useful for hemodynamically unstable patients. Unlike intermittent hemodialysis, which is faster, CRRT provides a gentler approach over 24 hours, closely mimicking the function of natural kidneys. However, CRRT is not ideal for patients with...
129