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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Crit+Care
2017 ; 21
(1
): 275
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gab.com Text
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An isolated elevation in blood urea level is not uraemia and not an indication
for renal replacement therapy in the ICU
#MMPMID29132411
Mackenzie J
; Chacko B
Crit Care
2017[Nov]; 21
(1
): 275
PMID29132411
show ga
The decision to initiate renal replacement therapy (RRT) and the optimal timing
for commencement is a difficult decision faced by clinicians when treating acute
kidney injury (AKI) in the intensive care setting. Without clinically significant
ureamic symptoms or emergent indications (electrolyte abnormalities, volume
overload) the timing of RRT initiation remains contentious and inconsistent
across health providers. Current trends of initiating RRT in the ICU are often
based on isolated blood urea levels without clear guidelines demonstrating an
upper limit for treatment. Although the appropriate upper limit remains unclear,
it is reasonable to conclude that a blood urea level less than 40 mmol/L is not
in itself an indication for RRT, especially in the absence of supporting evidence
of kidney impairment (anuria, elevated serum creatinine), presenting a welcome
reminder to treat the patient and not a number.
|Acute Kidney Injury/diagnosis/therapy
[MESH]
|Humans
[MESH]
|Intensive Care Units/organization & administration
[MESH]