Document Detail


New insights on intravenous fluids, diuretics and acute kidney injury.
MedLine Citation:
PMID:  18802369     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Derek R Townsend; Sean M Bagshaw
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Publication Detail:
Type:  Journal Article; Review     Date:  2008-09-18
Journal Detail:
Title:  Nephron. Clinical practice     Volume:  109     ISSN:  1660-2110     ISO Abbreviation:  Nephron Clin Pract     Publication Date:  2008  
Date Detail:
Created Date:  2008-09-19     Completed Date:  2009-01-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101159763     Medline TA:  Nephron Clin Pract     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  c206-16     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2008 S. Karger AG, Basel.
Affiliation:
Division of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta Hospital, University of Alberta, Edmonton, Alta., Canada.
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MeSH Terms
Descriptor/Qualifier:
Critical Care / trends*
Diuretics / therapeutic use*
Fluid Therapy / adverse effects,  methods*,  trends*
Humans
Kidney Failure, Acute / diagnosis,  etiology,  therapy*
Chemical
Reg. No./Substance:
0/Diuretics

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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