| New insights on intravenous fluids, diuretics and acute kidney injury. | |
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MedLine Citation:
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PMID: 18802369 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Acute kidney injury (AKI) is commonly and increasingly encountered in patients with critical illness. Fluid therapy is the cornerstone for the prevention and management of critically ill patients with AKI. New data have emerged that have raised concern that specific types of fluid (i.e. hydroxyethylstarch) may either contribute to or exacerbate AKI. Additional data have accumulated to indicate that the unnecessary accumulation of fluid and volume overload can negatively impact clinical outcomes. This finding may be further compounded in patients with oliguric AKI where solute and free water elimination are impaired. Diuretic therapy in AKI remains controversial. However, diuretic use is common, despite a paucity of evidence to show improved clinical outcomes. There are few therapeutic interventions proven to impact the clinical course and outcome of critically ill patients with established AKI. Current management strategies center largely on supportive care, with rapid resuscitation, removal of the stimulus contributing to AKI, judicious avoidance of complications, and allowing time for recovery. In this review, we explore recent insights on intravenous fluid therapy, volume overload, and diuretic therapy in the context of the critically ill patients with AKI. |
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Authors:
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Derek R Townsend; Sean M Bagshaw |
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Publication Detail:
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Type: Journal Article; Review Date: 2008-09-18 |
Journal Detail:
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Title: Nephron. Clinical practice Volume: 109 ISSN: 1660-2110 ISO Abbreviation: Nephron Clin Pract Publication Date: 2008 |
Date Detail:
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Created Date: 2008-09-19 Completed Date: 2009-01-06 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101159763 Medline TA: Nephron Clin Pract Country: Switzerland |
Other Details:
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Languages: eng Pagination: c206-16 Citation Subset: IM |
Copyright Information:
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Copyright (c) 2008 S. Karger AG, Basel. |
Affiliation:
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Division of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta Hospital, University of Alberta, Edmonton, Alta., Canada. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Critical Care
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trends* Diuretics / therapeutic use* Fluid Therapy / adverse effects, methods*, trends* Humans Kidney Failure, Acute / diagnosis, etiology, therapy* |
| Chemical | |
Reg. No./Substance:
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0/Diuretics |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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