RSS-Feed abonnieren
Bitte kopieren Sie die angezeigte URL und fügen sie dann in Ihren RSS-Reader ein.
https://www.thieme-connect.de/rss/thieme/de/10.1055-s-00000075.xml
PDF herunterladen
Semin Respir Crit Care Med 2006; 27(3): 262-273
DOI: 10.1055/s-2006-945527
DOI: 10.1055/s-2006-945527
Acute Renal Failure in the Intensive Care Unit
Weitere Informationen
Publikationsverlauf
Publikationsdatum:
21. Juni 2006 (online)
ABSTRACT
Acute renal failure (ARF) is a common complication in critically ill patients, with ARF requiring renal replacement therapy (RRT) developing in ~5 to 10% of intensive care unit (ICU) patients. Epidemiological studies have demonstrated that ARF is an independent risk factor for mortality. Interventions to prevent the development of ARF are currently limited to a small number of settings, primarily radiocontrast nephropathy and rhabdomyolysis. There are no effective pharmacological agents for the treatment of established ARF. Renal replacement therapy remains the primary treatment for patients with severe ARF; however, the data guiding selection of modality of RRT and the optimal timing of initiation and dose of therapy are inconclusive. This review focuses on the epidemiology and diagnostic approach to ARF in the ICU and summarizes our current understanding of therapeutic approaches including RRT.
KEYWORDS
Acute renal failure - renal replacement therapy
REFERENCES
- 1 Feest T G, Round A, Hamad S. Incidence of severe acute renal failure in adults: results of a community based study. BMJ. 1993; 306 481-483
- 2 Liano F, Pascual J. Epidemiology of acute renal failure: a prospective, multicenter, community-based study. Madrid Acute Renal Failure Study Group. Kidney Int. 1996; 50 811-818
- 3 Kaufman J, Dhakal M, Patel B, Hamburger R. Community-acquired acute renal failure. Am J Kidney Dis. 1991; 17 191-198
- 4 Nash K, Hafeez A, Hou S. Hospital-acquired renal insufficiency. Am J Kidney Dis. 2002; 39 930-936
- 5 Hou S H, Bushinsky D A, Wish J B, Cohen J J, Harrington J T. Hospital-acquired renal insufficiency: a prospective study. Am J Med. 1983; 74 243-248
- 6 de Mendonca A, Vincent J L, Suter P M et al.. Acute renal failure in the ICU: risk factors and outcome evaluated by the SOFA score. Intensive Care Med. 2000; 26 915-921
- 7 Metnitz P G, Krenn C G, Steltzer H et al.. Effect of acute renal failure requiring renal replacement therapy on outcome in critically ill patients. Crit Care Med. 2002; 30 2051-2058
- 8 Uchino S, Kellum J A, Bellomo R et al.. Acute renal failure in critically ill patients: a multinational, multicenter study. JAMA. 2005; 294 813-818
- 9 Clermont G, Acker C G, Angus D C, Sirio C A, Pinsky M R, Johnson J P. Renal failure in the ICU: comparison of the impact of acute renal failure and end-stage renal disease on ICU outcomes. Kidney Int. 2002; 62 986-996
- 10 Chertow G M, Christiansen C L, Cleary P D, Munro C, Lazarus J M. Prognostic stratification in critically ill patients with acute renal failure requiring dialysis. Arch Intern Med. 1995; 155 1505-1511
- 11 Guérin C, Girard R, Selli J M, Perdrix J P, Ayzac L. Initial versus delayed acute renal failure in the intensive care unit. A multicenter prospective epidemiological study. Rhone-Alpes Area Study Group on Acute Renal Failure. Am J Respir Crit Care Med. 2000; 161 872-879
- 12 Maher E R, Robinson K N, Scoble J E et al.. Prognosis of critically ill patients with acute renal failure: APACHE II score and other predictive factors. Q J Med. 1989; 72 857-866
- 13 Ronco C, Bellomo R, Homel P et al.. Effects of different doses in continuous veno-venous haemofiltration on outcomes of acute renal failure: a prospective randomised trial. Lancet. 2000; 356 26-30
- 14 Mehta R L, Pascual M T, Soroko S et al.. Spectrum of acute renal failure in the intensive care unit: the PICARD experience. Kidney Int. 2004; 66 1613-1621
- 15 Levy E M, Viscoli C M, Horwitz R I. The effect of acute renal failure on mortality: a cohort analysis. JAMA. 1996; 275 1489-1494
- 16 Joannidis M, Metnitz P G. Epidemiology and natural history of acute renal failure in the ICU. Crit Care Clin. 2005; 21 239-249
- 17 Chertow G M, Levy E M, Hammermeister K E, Grover F, Daley J. Independent association between acute renal failure and mortality following cardiac surgery. Am J Med. 1998; 104 343-348
- 18 Liano F, Junco E, Pascual J, Madero R, Verde E. The spectrum of acute renal failure in the intensive care unit compared with that seen in other settings. The Madrid Acute Renal Failure Study Group. Kidney Int Suppl. 1998; 66 S16-S24
- 19 Klenzak J, Himmelfarb J. Sepsis and the kidney. Crit Care Clin. 2005; 21 211-222
- 20 Badr K F, Kelley V E, Rennke H G, Brenner B M. Roles for thromboxane A2 and leukotrienes in endotoxin-induced acute renal failure. Kidney Int. 1986; 30 474-480
- 21 Kikeri D, Pennell J P, Hwang K H, Jacob A I, Richman A V, Bourgoignie J J. Endotoxemic acute renal failure in awake rats. Am J Physiol. 1986; 250 F1098-F1106
- 22 Brenner M, Schaer G L, Mallory D L, Suffredini A F, Parrillo J E. Detection of renal blood flow abnormalities in septic and critically ill patients using a newly designed indwelling thermodilution renal vein catheter. Chest. 1990; 98 170-179
- 23 Knotek M, Rogachev B, Wang W et al.. Endotoxemic renal failure in mice: role of tumor necrosis factor independent of inducible nitric oxide synthase. Kidney Int. 2001; 59 2243-2249
- 24 Cunningham P N, Dyanov H M, Park P, Wang J, Newell K A, Quigg R J. Acute renal failure in endotoxemia is caused by TNF acting directly on TNF receptor-1 in kidney. J Immunol. 2002; 168 5817-5823
- 25 Bernard G R, Vincent J L, Laterre P F et al.. Efficacy and safety of recombinant human activated protein C for severe sepsis. N Engl J Med. 2001; 344 699-709
- 26 Allen D A, Harwood S, Varagunam M, Raftery M J, Yaqoob M M. High glucose-induced oxidative stress causes apoptosis in proximal tubular epithelial cells and is mediated by multiple caspases. FASEB J. 2003; 17 908-910
- 27 Wan L, Bellomo R, Di Giantomasso D, Ronco C. The pathogenesis of septic acute renal failure. Curr Opin Crit Care. 2003; 9 496-502
- 28 Molitoris B A, Sutton T A. Endothelial injury and dysfunction: role in the extension phase of acute renal failure. Kidney Int. 2004; 66 496-499
- 29 Ysebaert D K, De Greef K E, De Beuf A et al.. T cells as mediators in renal ischemia/reperfusion injury. Kidney Int. 2004; 66 491-496
- 30 Friedewald J J, Rabb H. Inflammatory cells in ischemic acute renal failure. Kidney Int. 2004; 66 486-491
- 31 Bonventre J V, Zuk A. Ischemic acute renal failure: an inflammatory disease?. Kidney Int. 2004; 66 480-485
- 32 Solomon R, Werner C, Mann D, D'Elia J, Silva P. Effects of saline, mannitol, and furosemide to prevent acute decreases in renal function induced by radiocontrast agents. N Engl J Med. 1994; 331 1416-1420
- 33 Mueller C, Buerkle G, Buettner H J et al.. Prevention of contrast media-associated nephropathy: randomized comparison of 2 hydration regimens in 1620 patients undergoing coronary angioplasty. Arch Intern Med. 2002; 162 329-336
- 34 Merten G J, Burgess W P, Gray L V et al.. Prevention of contrast-induced nephropathy with sodium bicarbonate: a randomized controlled trial. JAMA. 2004; 291 2328-2334
- 35 Tepel M, van der Giet M, Schwarzfeld C, Laufer U, Liermann D, Zidek W. Prevention of radiographic-contrast-agent-induced reductions in renal function by acetylcysteine. N Engl J Med. 2000; 343 180-184
- 36 Pannu N, Manns B, Lee H, Tonelli M. Systematic review of the impact of N-acetylcysteine on contrast nephropathy. Kidney Int. 2004; 65 1366-1374
- 37 Nallamothu B K, Shojania K G, Saint S et al.. Is acetylcysteine effective in preventing contrast-related nephropathy? A meta-analysis. Am J Med. 2004; 117 938-947
- 38 Bagshaw S M, Ghali W A. Theophylline for prevention of contrast-induced nephropathy: a systematic review and meta-analysis. Arch Intern Med. 2005; 165 1087-1093
- 39 Weisbord S D, Palevsky P M. Radiocontrast-induced acute renal failure. J Intensive Care Med. 2005; 20 63-75
- 40 Barrett B J, Carlisle E J. Meta-analysis of the relative nephrotoxicity of high- and low-osmolality iodinated contrast media. Radiology. 1993; 188 171-178
- 41 Rudnick M R, Goldfarb S, Wexler L et al.. Nephrotoxicity of ionic and nonionic contrast media in 1196 patients: a randomized trial. The Iohexol Cooperative Study. Kidney Int. 1995; 47 254-261
- 42 Aspelin P, Aubry P, Fransson S G, Strasser R, Willenbrock R, Berg K J. Nephrotoxic effects in high-risk patients undergoing angiography. N Engl J Med. 2003; 348 491-499
- 43 Bartholomew B A, Harjai K J, Dukkipati S et al.. Impact of nephropathy after percutaneous coronary intervention and a method for risk stratification. Am J Cardiol. 2004; 93 1515-1519
- 44 Marenzi G, Lauri G, Assanelli E et al.. Contrast-induced nephropathy in patients undergoing primary angioplasty for acute myocardial infarction. J Am Coll Cardiol. 2004; 44 1780-1785
- 45 Ron D, Taitelman U, Michaelson M, Bar-Joseph G, Bursztein S, Better O S. Prevention of acute renal failure in traumatic rhabdomyolysis. Arch Intern Med. 1984; 144 277-280
- 46 Gunal A I, Celiker H, Dogukan A et al.. Early and vigorous fluid resuscitation prevents acute renal failure in the crush victims of catastrophic earthquakes. J Am Soc Nephrol. 2004; 15 1862-1867
- 47 Zager R A. Studies of mechanisms and protective maneuvers in myoglobinuric acute renal injury. Lab Invest. 1989; 60 619-629
- 48 Zager R A. Combined mannitol and deferoxamine therapy for myohemoglobinuric renal injury and oxidant tubular stress: mechanistic and therapeutic implications. J Clin Invest. 1992; 90 711-719
- 49 Brown C V, Rhee P, Chan L, Evans K, Demetriades D, Velmahos G C. Preventing renal failure in patients with rhabdomyolysis: do bicarbonate and mannitol make a difference?. J Trauma. 2004; 56 1191-1196
- 50 Tuttle K R, Worrall N K, Dahlstrom L R, Nandagopal R, Kausz A T, Davis C L. Predictors of ARF after cardiac surgical procedures. Am J Kidney Dis. 2003; 41 76-83
- 51 Lassnigg A, Schmidlin D, Mouhieddine M et al.. Minimal changes of serum creatinine predict prognosis in patients after cardiothoracic surgery: a prospective cohort study. J Am Soc Nephrol. 2004; 15 1597-1605
- 52 Thakar C V, Arrigain S, Worley S, Yared J P, Paganini E P. A clinical score to predict acute renal failure after cardiac surgery. J Am Soc Nephrol. 2005; 16 162-168
- 53 Lassnigg A, Donner E, Grubhofer G, Presterl E, Druml W, Hiesmayr M. Lack of renoprotective effects of dopamine and furosemide during cardiac surgery. J Am Soc Nephrol. 2000; 11 97-104
- 54 Sward K, Valsson F, Odencrants P, Samuelsson O, Ricksten S E. Recombinant human atrial natriuretic peptide in ischemic acute renal failure: a randomized placebo-controlled trial. Crit Care Med. 2004; 32 1310-1315
- 55 Van Belleghem Y, Caes F, Maene L, Van Overbeke H, Moerman A, Van Nooten G. Off-pump coronary surgery: surgical strategy for the high-risk patient. Cardiovasc Surg. 2003; 11 75-79
- 56 Ascione R, Nason G, Al-Ruzzeh S, Ko C, Ciulli F, Angelini G D. Coronary revascularization with or without cardiopulmonary bypass in patients with preoperative nondialysis-dependent renal insufficiency. Ann Thorac Surg. 2001; 72 2020-2025
- 57 Schwann N M, Horrow J C, Strong III M D, Chamchad D, Guerraty A, Wechsler A S. Does off-pump coronary artery bypass reduce the incidence of clinically evident renal dysfunction after multivessel myocardial revascularization?. Anesth Analg. 2004; 99 959-964
- 58 Weisberg L S, Kurnik P B, Kurnik B R. Dopamine and renal blood flow in radiocontrast-induced nephropathy in humans. Ren Fail. 1993; 15 61-68
- 59 Olsen N V, Olsen M H, Bonde J et al.. Dopamine natriuresis in salt-repleted, water-loaded humans: a dose-response study. Br J Clin Pharmacol. 1997; 43 509-520
- 60 Bellomo R, Chapman M, Finfer S, Hickling K, Myburgh J. Low-dose dopamine in patients with early renal dysfunction: a placebo-controlled randomised trial. Australian and New Zealand Intensive Care Society (ANZICS) Clinical Trials Group. Lancet. 2000; 356 2139-2143
- 61 Friedrich J O, Adhikari N, Herridge M S, Beyene J. Meta-analysis: low-dose dopamine increases urine output but does not prevent renal dysfunction or death. Ann Intern Med. 2005; 142 510-524
- 62 Tumlin J A, Finkel K W, Murray P T, Samuels J, Cotsonis G, Shaw A D. Fenoldopam mesylate in early acute tubular necrosis: a randomized, double-blind, placebo-controlled clinical trial. Am J Kidney Dis. 2005; 46 26-34
- 63 Borirakchanyavat V, Vongsthongsri M, Sitprija V. Furosemide and acute renal failure. Postgrad Med J. 1978; 54 30-32
- 64 Brown C B, Ogg C S, Cameron J S. High dose frusemide in acute renal failure: a controlled trial. Clin Nephrol. 1981; 15 90-96
- 65 Mehta R L, Pascual M T, Soroko S, Chertow G M. Diuretics, mortality, and nonrecovery of renal function in acute renal failure. JAMA. 2002; 288 2547-2553
- 66 Uchino S, Doig G S, Bellomo R et al.. Diuretics and mortality in acute renal failure. Crit Care Med. 2004; 32 1669-1677
- 67 Liangos O, Rao M, Balakrishnan V S, Pereira B J, Jaber B L. Relationship of urine output to dialysis initiation and mortality in acute renal failure. Nephron Clin Pract. 2005; 99 c56-c60
- 68 Hirschberg R, Kopple J, Lipsett P et al.. Multicenter clinical trial of recombinant human insulin-like growth factor I in patients with acute renal failure. Kidney Int. 1999; 55 2423-2432
- 69 Acker C G, Flick R, Shapiro R et al.. Thyroid hormone in the treatment of post-transplant acute tubular necrosis (ATN). Am J Transplant. 2002; 2 57-61
- 70 Acker C G, Singh A R, Flick R P, Bernardini J, Greenberg A, Johnson J P. A trial of thyroxine in acute renal failure. Kidney Int. 2000; 57 293-298
- 71 Teschan P E, Baxter C R, O'Brien T F, Freyhof J N, Hall W H. Prophylactic hemodialysis in the treatment of acute renal failure. Ann Intern Med. 1960; 53 992-1016
- 72 Easterling R E, Forland M. A five year experience with prophylactic dialysis for acute renal failure. Trans Am Soc Artif Intern Organs. 1964; 10 200-208
- 73 Parsons F M, Hobson S M, Blagg C R, McCracken C B. Optimum time for dialysis in acute reversible renal failure: description and value of an improved dialyser with large surface area. Lancet. 1961; 1 129-134
- 74 Fischer R P, Griffen Jr W O, Reiser M, Clark D S. Early dialysis in the treatment of acute renal failure. Surg Gynecol Obstet. 1966; 123 1019-1023
- 75 Kleinknecht D, Jungers P, Chanard J, Barbanel C, Ganeval D. Uremic and non-uremic complications in acute renal failure: evaluation of early and frequent dialysis on prognosis. Kidney Int. 1972; 1 190-196
- 76 Conger J D. A controlled evaluation of prophylactic dialysis in post-traumatic acute renal failure. J Trauma. 1975; 15 1056-1063
- 76a Gillum D M, Dixon B M, Yanover M J. The role of intensive dialysis in acute renal failure. Clin Nephrol. 1986; 25 249-255
- 77 Gettings L G, Reynolds H N, Scalea T. Outcome in post-traumatic acute renal failure when continuous renal replacement therapy is applied early vs. late. Intensive Care Med. 1999; 25 805-813
- 78 Elahi M M, Lim M Y, Joseph R N, Dhannapuneni R R, Spyt T J. Early hemofiltration improves survival in post-cardiotomy patients with acute renal failure. Eur J Cardiothorac Surg. 2004; 26 1027-1031
- 79 Bouman C S, Oudemans-Van Straaten H M, Tijssen J G, Zandstra D F, Kesecioglu J. Effects of early high-volume continuous venovenous hemofiltration on survival and recovery of renal function in intensive care patients with acute renal failure: a prospective, randomized trial. Crit Care Med. 2002; 30 2205-2211
- 80 Bellomo R, Ronco C, Mehta R. Nomenclature for continuous renal replacement therapies. Am J Kidney Dis. 1996; 28(suppl 3) S2-S7
- 81 Ronco C, Bellomo R. Continuous renal replacement therapy: evolution in technology and current nomenclature. Kidney Int. 1998; 53(suppl 66) S160-S164
- 82 Bellomo R, Parkin G, Love J, Boyce N. A prospective comparative study of continuous arteriovenous hemodiafiltration and continuous venovenous hemodiafiltration in critically ill patients. Am J Kidney Dis. 1993; 21 400-404
- 83 Kellum J A, Johnson J P, Kramer D, Palevsky P, Brady J J, Pinsky M R. Diffusive vs. convective therapy: effects on mediators of inflammation in patient with severe systemic inflammatory response syndrome. Crit Care Med. 1998; 26 1995-2000
- 84 Swartz R D, Messana J M, Orzol S, Port F K. Comparing continuous hemofiltration with hemodialysis in patients with severe acute renal failure. Am J Kidney Dis. 1999; 34 424-432
- 85 Guérin C, Girard R, Selli J M, Ayzac L. Intermittent versus continuous renal replacement therapy for acute renal failure in intensive care units: results from a multicenter prospective epidemiological survey. Intensive Care Med. 2002; 28 1411-1418
- 86 Mehta R L, McDonald B, Gabbai F B et al.. A randomized clinical trial of continuous versus intermittent dialysis for acute renal failure. Kidney Int. 2001; 60 1154-1163
- 87 Kellum J A, Angus D C, Johnson J P et al.. Continuous versus intermittent renal replacement therapy: a meta-analysis. Intensive Care Med. 2002; 28 29-37
- 88 Tonelli M, Manns B, Feller-Kopman D. Acute renal failure in the intensive care unit: a systematic review of the impact of dialytic modality on mortality and renal recovery. Am J Kidney Dis. 2002; 40 875-885
- 89 Augustine J J, Sandy D, Seifert T H, Paganini E P. A randomized controlled trial comparing intermittent with continuous dialysis in patients with ARF. Am J Kidney Dis. 2004; 44 1000-1007
- 90 Manns B, Doig C J, Lee H et al.. Cost of acute renal failure requiring dialysis in the intensive care unit: clinical and resource implications of renal recovery. Crit Care Med. 2003; 31 449-455
- 91 Jacka M J, Ivancinova X, Gibney R T. Continuous renal replacement therapy improves renal recovery from acute renal failure. Can J Anaesth. 2005; 52 327-332
- 92 Palevsky P, Baldwin I, Davenport A, Goldstein S, Paganini E. Renal replacement therapy and the kidney: minimizing the impact of renal replacement therapy on recovery of acute renal failure. Curr Opin Crit Care. 2005; 11 , In press
- 93 Phu N H, Hien T T, Mai N T et al.. Hemofiltration and peritoneal dialysis in infection-associated acute renal failure in Vietnam. N Engl J Med. 2002; 347 895-902
- 94 Kielstein J T, Kretschmer U, Ernst T et al.. Efficacy and cardiovascular tolerability of extended dialysis in critically ill patients: a randomized controlled study. Am J Kidney Dis. 2004; 43 342-349
- 95 Schiffl H, Lang S M, Fischer R. Daily hemodialysis and the outcome of acute renal failure. N Engl J Med. 2002; 346 305-310
- 96 Bonventre J V. Daily hemodialysis: will treatment each day improve the outcome in patients with acute renal failure?. N Engl J Med. 2002; 346 362-364
- 97 Paganini E P, Taployai M, Gormastic M et al.. Establishing a dialysis therapy/patient outcome link in intensive care unit acute dialysis. Am J Kidney Dis. 1996; 28(suppl 3) S81-S89
- 98 Kellum J A, Mehta R L, Angus D C, Palevsky P, Ronco C. The first international consensus conference on continuous renal replacement therapy. Kidney Int. 2002; 62 1855-1863
- 99 Palevsky P M, O'Connor T, Zhang J H, Star R A, Smith M W. Design of the VA/NIH Acute Renal Failure Trial Network (ATN) Study: Intensive versus conventional renal support in acute renal failure. Clin Trials. 2005; 2 423-435
Paul M PalevskyM.D.
Rm. 7E123 (111F-U), VA Pittsburgh Healthcare System
University Drive Division, Pittsburgh, PA 15240
eMail: palevsky@pitt.edu