HARD DECISIONS IN INTENSIVE CARE UNIT

Intensivecareunitkapak

RENAL FAILURE IN INTENSIVE CARE UNIT

Elmas Hacısalihoğlu

Dr. İsmail Fehmi Cumalioğlu City Hospital, Department of Intensive Care, Tekirdağ, Türkiye

Hacısalihoğlu E. Renal Failure in Intensive Care Unit. In: Turan S, editor. Hard Decisions in Intensive Care Unit. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.51-60.

ABSTRACT

Renal failure (acute kidney injury (AKI)/chronic renal failure (CKD)) is associated with high mortality in intensive care unit patients. RIFLE (Risk, Injury, Failure, Loss of kidney function, Endstage renal failure), AKIN (Acute Kıdney Injury Network) and Improving Global Outcomes (KDIGO) criteria are used for diagnosis. Studies have suggested that new biomarkers can also be used in diagnosis. How ever, these tests have not yet been used routinely because they are expensive and at a study. There are prerenal, renal and postrenal causes in etiology. However, it becomes difficult to find the underlying cause in intensive care unit patients due to the coexistence of many factors such as hemodynamic instability, multiple drug use, and vasopressor agent use. The most effective strategies to prevent AKI are maintaining hemodynamic stabilization and volume assessment. Treatment is the treatment of the underlying cause, but in later stages and in urgent indications, treatments such as hemodialysis (HD) and continuous renal replacement therapies (CRRT) may also be considered. Our first aim in intensive care unit patients is to prevent AKI. Our secondary aim should be to manage complications and plan treatment in patients who develop AKI. In addition, it should not be forgotten that patients with AKI or CKD diagnoses are a special patient group in terms of drug doses and treatment. More randomized controlled studies with these patient groups are needed.

Keywords: Acute kidney injury; Physiopathology; Prevention; Treatment

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