Skip to main content

Akutes Nierenversagen und Nierenersatztherapie

  • Chapter
NeuroIntensiv
  • 3754 Accesses

Zusammenfassung

Das akute Nierenversagen ist ein in der Intensivmedizin häufi ges Krankheitsbild. Es tritt in fast der Hälfte der Fälle im Rahmen eines Multiorganversagens oder eines septischen Schockgeschehens auf [52], wobei die Prognose trotz der Möglichkeit der Nierenersatztherapie von der Grunderkrankung abhängig ist. Darüber hinaus ist das akute Nierenversagen ein unabhängiger Risikofaktor für die Mortalität von Intensivpatienten [25], [30], [32].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 99.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Similar content being viewed by others

Literatur

  1. Amanzadeh J, Reilly RF (2006) Hypophoshatemia: an evidencebased approach to its clinical consequences and management. Nat Clin Pract Nephrol 2:136–148

    Article  PubMed  CAS  Google Scholar 

  2. Angstwurm MW, Engelmann L, Zimmermann T, Lehmann C, Spes CH, Abel P, Strauß R, Meier-Hellmann A, Insel R, Radke J, Schüttler J, Gärtner R (2007) Selenium in Intensive Care (SIC): Results of a prospective randomized, placebo-controlled, multiple-center study in patients with severe systemic inflammatory response syndrome, sepsis and septic shock. Crit Care Med 35:118–126

    Article  PubMed  CAS  Google Scholar 

  3. Asif A, Epstein M (2004) Prevention of radiocontrast-induced nephropathy. Am J Kidney Dis 44:12–24

    Article  PubMed  CAS  Google Scholar 

  4. Bagshaw SM, Delaney A, Haase M, Ghali WA, Bellomo R (2007) Loop diuretics in the management of acute renal failure: a systematic review and meta-analysis. Crit Care Resusc 9:60–68

    PubMed  Google Scholar 

  5. Bagshaw SM, Berthiaume LR, Delaney A, Bellomo R (2008) Continuous versus intermittent renal replacement therapy for critically ill patients with acute kidney injury: A meta-analysis. Crit Care Med 36:610–617

    Article  PubMed  Google Scholar 

  6. Bagshaw SM, Uchino S, Bellomo R, Morimatsu M, Morgera S, Schetz M, Tan I, Bouman C, Macedo E, Gibney N, Tolwani A, Oudemans-van Straaten HM, Ronco C, Kellum JA (2009) Timing of renal replacement therapy and clinical outcomes in critically ill patients with severe acute kidney injury. J Crit Care 24:129–140

    Article  PubMed  Google Scholar 

  7. Bellomo R, Ronco C, Kellum JA, Mehta RL, Palevsky P and the ADQI workgroup (2004) Acute renal failure - definition, outcome measures, animal models, fluid therapy and information technology needs. Crit Care 8:R204-R212

    Article  PubMed  Google Scholar 

  8. Bellomo R, Cass A, Cole L, Finfer S, Gallagher M, Lo S, McArthur C, McGuinness S, Myburgh J, Norton R, Scheinkestel C, Su S (2009) Intensity of continuous renal-replacement therapy in critically ill patients. N Engl J Med 361:1627–1638

    Article  PubMed  Google Scholar 

  9. Brater DC (1998) Diuretic therapy. N Engl J Med 339:387–395

    Article  PubMed  CAS  Google Scholar 

  10. Brunkhorst FM, Engel C, Bloos F, Meier-Hellmann A, Ragaller M, Weiler N, Moerer O, Gruendling M, Oppert M, Grond S, OlthoffD, Jaschinski U, John S, Roissant R, Welte T, Schaefer M, Kern P, Kuhnt E, Kiehntopf M, Hartog C, Natanson C, Loeffler M, Reinhardt K (2008) Intensive insulin therapy and pentastarch resuscitation in severe sepsis. N Engl J Med 358:125–139

    Article  PubMed  CAS  Google Scholar 

  11. Cole L, Bellomo R, Hart G, Journois D, Davenport P, Tipping P, Ronco C (2002) A phase II randomized, controlled trial of continuous hemofiltration in sepsis. Crit Care Med 30:100–106

    Article  PubMed  CAS  Google Scholar 

  12. Cox CD, Tsikouris JD (2004) Preventing contrast nephropathy: What ist the best strategy? J Clin Pharmacol 44:327–337

    Article  PubMed  Google Scholar 

  13. Druml W (1999) Metabolic aspects of continuous renal replacement therapies. Kidney Int 56:S56-S61

    Article  Google Scholar 

  14. Fliser D, Kielstein JT (2004) A single-pass batch dialysis system: an ideal dialysis method for the patient in intensive care with acute renal failure. Curr Opin Crit Care 10:483–488

    Article  PubMed  Google Scholar 

  15. Friedrich JO, Adhikari N, Herridge MS, Beyene J (2005) Metaanalysis: Low-dose dopamine increases urine output but does not prevent renal dysfunction or death. Ann Intern Med 142:510–524

    PubMed  CAS  Google Scholar 

  16. Gabriel A, Müller E, Tarnow J (2001) Therapie des akuten Nierenversagens - Konzepte und Kontroversen (Teil I - Pharmakologische Behandlung und experimentelle Therapieansätze). Anästhesiol Intensivmed Notfallmed Schmerzther 36:134–142

    Article  PubMed  CAS  Google Scholar 

  17. Gabriel A, Müller E, Tarnow J (2001) Therapie des akuten Nierenversagens - Konzepte und Kontroversen (Teil II - Extrakorporale Nierenersatzverfahren und Peritonealdialyse). Anästhesiol Intensivmed Notfallmed Schmerzther 36:195–204

    Article  PubMed  CAS  Google Scholar 

  18. Ho KM, Sheridan DJ (2006) Meta-analysis of frusemide to prevent or treat acute renal failure. BMJ 333:420–426

    Article  PubMed  CAS  Google Scholar 

  19. Jakob SM (2004) Prevention of acute renal failure - fluid repletion and colloids. Int J Artif Organs 27:1043–1048

    PubMed  CAS  Google Scholar 

  20. Joannidis M, Metnitz B, Bauer P, Schusterschitz N, Moreno R, Druml W, Metnitz PG (2009) Acute kidney injury in critically ill patients classified by AKIN versus RIFLE using the SAPS 3 database. Intensive Care Med 35:1692–1702

    Article  PubMed  Google Scholar 

  21. Keller E (1995) Einfluß der kontinuierlichen Nierenersatztherapie auf die Pharmakokinetik von Arzneimitteln. Anästhesiologie und Intensivmedizin 36:300–306

    Google Scholar 

  22. Kellum Ja, Decker J (2001) Use of dopamine in acute renal failure: a meta-analysis. Crit Care Med 29:1526–1531

    Article  PubMed  CAS  Google Scholar 

  23. Kelly AM, Dwamena B, Cronin P, Bernstein SJ, Carlos RC (2008) Meta-analysis: Effectiveness of drugs for preventing contrastinduced nephropathy. Ann Int Med 148:284–294

    PubMed  Google Scholar 

  24. Lameire NH, De Vriese AS, Vanholder R (2003) Prevention and nondialytic treatment of acute renal failure. Curr Opin Crit Care 9:481–490

    Article  PubMed  Google Scholar 

  25. Levy EM, Viscoli CM, Horwitz RI (1996) The effect of acute renal failure on mortality. JAMA 275:1489–1494

    Article  PubMed  CAS  Google Scholar 

  26. Lin SM, Huang CD, Lin HC, Liu CY, Wang CH, Kuo HP (2006) A modified goal-directed protocol improves clinical outcomes in intensive care unit patients with septic shock: a randomized controlled trial. Shock 26:551–557

    Article  PubMed  Google Scholar 

  27. Mehta RL, Kellum JA, Shah SV, Molitoris BA, Ronco C, Warnock DG, Levin A (2007) Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury. Crit Care 11:R31-R38

    Article  PubMed  Google Scholar 

  28. Meier P, Ko DT, Tamura A, Tamhane U, Gurm HS (2009) Sodium bicarbonate-based hydration prevents contrast-induced nephropathy: a meta-analysis. BMJ 7:23

    Google Scholar 

  29. Merten GJ, Burgess WP, Gray LV, Hollemann JH, Roush TS, Kowalchuk GJ, Bersin RM, van Moore A, Simonton CA, Rittase RA, Norton HJ, Kennedy TP (2004) Prevention of contrast-induced nephropathy with sodium bicarbonate. JAMA 291:2328–2334

    Article  PubMed  CAS  Google Scholar 

  30. Metnitz PG, Krenn CG, Steltzer H, Lang T, Ploder J, Lenz K, Le Gall JR, Druml W (2002) Effect of acute renal failure requiring renal replacement therapy on outcome in critically ill patients. Crit Care Med 30:2051–2058

    Article  PubMed  Google Scholar 

  31. Morath C, Miftari N, Dikow R, Hainer C, Zeier M, Schwenger V, Weigand MA (2006) Nierenersatztherapie auf der Intensivstation. Anästhesist 55:901–914

    Article  CAS  Google Scholar 

  32. Oppert M, Engel C, Brunkhorst FM, Bogatsch H, Reinhardt K, Frei U, Eckhardt KU, Loeffler M, John S (2008) Acute renal failure in patients with severe sepsis and septic shock - a significant independent risk factor for mortality: results from the German prevalence study. Nephrol Dial Transplant 23:904–909

    Article  PubMed  Google Scholar 

  33. Oudemans-van Straaten H, Bosman RJ, Koopmans M, Van Der Voort PH, Wester JP, Van Der Spoel JI, Dijksman LM, Zandstra DF (2009) Citrate anticoagulation for continuous venovenous hemofiltration. Crit Care Med 37:545–552

    Article  PubMed  CAS  Google Scholar 

  34. Palevsky PM (2008) Indications and timing of renal replacement therapy in acute kidney injury. Crit Care Med 33 (Suppl):S224-S228

    Article  Google Scholar 

  35. Palevsky PM, Zhang JH, O´Connor TZ, Chertow GM, Crowley ST, Choudhury D, Finkel K, Kellum JA, Paganini E, Schein RM, Smith MW, Swanson KM, Thompson BT, Vijayan A, Watnick S, Star RA, Peduzzi P (2008) Intensity of renal support in critically ill patients with acute kidney injury. N Engl J Med 359:7–20

    Article  PubMed  CAS  Google Scholar 

  36. Pannu N, Manns B, Lee H, Tonelli M (2004) Systematic review of the impact of N-acetylcysteine on contrast nephropathy. Kidney Int 65:1366–1374

    Article  PubMed  CAS  Google Scholar 

  37. Payen D, de Pont AC, Sakr Y, Spies C, Reinhart K, Vincent JL (2008) A positive fluid balance is associated with a worse outcome in patients with acute renal failure. Crit Care 12:R74

    Article  PubMed  Google Scholar 

  38. Ragaller MJR, Theilen H, Koch T (2001) Volume replacement in critically ill patients with acute renal failure. J Am Soc Nephrol 12:S33-S39

    PubMed  Google Scholar 

  39. Redl-Wenzl EM, Armbruster C, Edelmann G, Fischl E, Kolacny M, Wechsler-Fördös A, Sporn P (1993) The effects of norepinephrine on hemodynamics and renal function in severe septic shock states. Intensive Care Med 19:151–154

    Article  PubMed  CAS  Google Scholar 

  40. Ricci Z, Cruz D, Ronco C (2008) The RIFLE criteria and mortality in acute kidney injury: A systemic review. Kidney International 73:538–546

    Article  PubMed  CAS  Google Scholar 

  41. Rivers E, Nguyen B, Havstad S, Ressler J, Muzzin A,, Knoblich B, Peterson E, Tomlanovich M (2001) Early goal directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med 345:1368–1377

    Article  PubMed  CAS  Google Scholar 

  42. Ronco C, Bellomo R, Homel P, Brendolan A, Dan M, Piccinni P, La Greca G (2000) Effects of different doses in continuous venovenous haemofiltration on outcomes of acute renal failure: a prospective randomised trial. Lancet 355:26–30

    Article  Google Scholar 

  43. Schabinski F, Oishi J, Tuche F, Luy A, Sakr Y, Bredle D, Hartog C, Reinhart K (2009) Effects of a predominantly hydroxyethyl starch (HES)-based and a predominantly non HES-based fluid therapy on renal function in surgical ICU patients. Intensive Care Med 35:1539–1547

    Article  PubMed  CAS  Google Scholar 

  44. Schiffl H, Lang SM, Fischer R (2002) Daily hemodialysis and the outcome of acute renal failure. N Engl J Med 346:305–310

    Article  PubMed  Google Scholar 

  45. Seabra VF, Balk EM, Liangos O, Sosa MA, Cendoroglo M, Jaber BL (2008) Timing of renal replacement therapy in acute renal failure: A meta-analysis. Am J Kidney Dis 52:272–284

    Article  PubMed  Google Scholar 

  46. Segal JM, Phang PT, Walley KR (1992) Low-dose dopamine hastens onset of gut ischemia in a porcine model of hemorrhagic shock. J Appl Physiol 73:1159–1164

    PubMed  CAS  Google Scholar 

  47. Simon S, Stille W (2000) Antibiotikatherapie in Klinik und Praxis. Schattauer, Stuttgart New York

    Google Scholar 

  48. Singer I, Epstein M (1998) Potential of dopamine A-1 agonists in the management of acute renal failure. Am J Kidney Dis 31:743–755

    Article  PubMed  CAS  Google Scholar 

  49. Swartz RD, Messana JM, Orzol S, Port FK (1999) Comparing continuous hemofiltration with hemodialysis in patients with severe acute renal failure. Am J Kidney Dis 34:424–432

    Article  PubMed  CAS  Google Scholar 

  50. Tepel M, Van Der Giet M, Schwarzfeld C, Laufer U, Liermann D, Zidek W (2000) Prevention of radiographic-contrast-agentinduced reductions in renal function by acetylcysteine. N Engl J Med 343:180–184

    Article  PubMed  CAS  Google Scholar 

  51. Townsend DR, Bagshaw SM (2008) New insights on intravenous fluids, diuretics and acute kidney injury. Nephron Clin Pract 109:c206-c216

    Article  PubMed  Google Scholar 

  52. Uchino S, Kellum JA, Bellomo R, Doig GS, Morimatsu H, Morgera S, Schetz M, Tan I, Bouman C, Macedo E, Gibney N, Tolwani A, Ronco C (2005) Acute renal failure in critically ill patients - a multinational, multicenter study. JAMA 294:813–818

    Article  PubMed  CAS  Google Scholar 

  53. Uehlinger DE, Jakob SM, Ferrari P, Eichelberger M, Huynh-Do U, Marti HP, Mohaupt MG, Vogt B, Rothen HU, Regli B, Takala J, Frey FJ (2005) Comparison of continous and intermittent renal replacement therapy for acute renal failure. Nephrol Dial Transplant 20:1630–1637

    Article  PubMed  Google Scholar 

  54. Van Den Berghe G, de Zegher F (1996) Anterior pituitary function during critical illness and dopamine treatment. Crit Care Med 25:1580–1590

    Article  Google Scholar 

  55. Vivino G, Antonelli M, Moro ML, Cottini F, Conti G, Bufi M, Cannata F, Gasparetto A (1998) Risk factors for acute renal failure in trauma patients. Intensive Care Med 24:808–814

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2012 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Sydow, K. (2012). Akutes Nierenversagen und Nierenersatztherapie. In: Schwab, S., Schellinger, P., Werner, C., Unterberg, A., Hacke, W. (eds) NeuroIntensiv. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-16911-3_16

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-16911-3_16

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-16910-6

  • Online ISBN: 978-3-642-16911-3

  • eBook Packages: Medicine (German Language)

Publish with us

Policies and ethics