Prevention of acute kidney injury in critically ill patients : Recommendations from the renal section of the DGIIN, ÖGIAIN and DIVI

Journal article


Publication Details

Author(s): Joannidis M, Klein SJ, John S, Schmitz M, Czock D, Druml W, Joerres A, Kindgen-Milles D, Kielstein JT, Oppert M, Schwenger V, Willam C, Zarbock A
Journal: Medizinische Klinik - Intensivmedizin und Notfallmedizin
Publication year: 2018
Volume: 113
Journal issue: 5
Pages range: 358-369
ISSN: 2193-6218
eISSN: 2193-6226


Abstract

BACKGROUND: Acute kidney injury (AKI) has both high mortality and morbidity.
OBJECTIVES: To prevent the occurrence of AKI, current recommendations from the renal section of the DGIIN (Deutschen Gesellschaft für Internistische Intensivmedizin und Notfallmedizin), ÖGIAIN (Österreichischen Gesellschaft für Internistische und Allgemeine Intensivmedizin und Notfallmedizin) and DIVI (Deutschen Interdisziplinären Vereinigung für Intensiv- und Notfallmedizin) are stated.
MATERIALS AND METHODS: The recommendations stated in this paper are based on the current Kidney Disease Improving Global Outcomes (KDIGO) guidelines, the published statements of the "Working Group on Prevention, AKI section of the European Society of Intensive Care Medicine" and the expert knowledge and clinical experience of the authors.
RESULTS: Currently there are no approved clinically effective drugs for the prevention of AKI. Therefore the mainstay of prevention is the optimization of renal perfusion by improving the mean arterial pressure (>65 mm Hg, higher target may be considered in hypertensive patients). This can be done by vasopressors, preferably norepinephrine and achieving or maintaining euvolemia. Hyperhydration that can lead to AKI itself should be avoided. In patients with maintained diuresis this can be done by diuretics that are per se no preventive drug for AKI. Radiocontrast enhanced imaging should not be withheld from patients at risk for AKI; if indicated, however, the contrast media should be limited to the smallest possible volume.


FAU Authors / FAU Editors

Willam, Carsten Prof. Dr.
Medizinische Klinik 4 - Nephrologie und Hypertensiologie


External institutions with authors

Heinrich-Heine-Universität Düsseldorf
Klinikum Ernst von Bergmann
Klinikum Stuttgart
Krankenhaus Köln-Merheim - Klinikum der Universität Witten/Herdecke
Medizinische Universität Innsbruck
Städtisches Klinikum Braunschweig
Städtisches Klinikum Solingen
Universitätsklinikum Heidelberg
Universitätsklinikum Münster
Vienna General Hospital / Allgemeines Krankenhaus der Stadt Wien (AKH)


How to cite

APA:
Joannidis, M., Klein, S.J., John, S., Schmitz, M., Czock, D., Druml, W.,... Zarbock, A. (2018). Prevention of acute kidney injury in critically ill patients : Recommendations from the renal section of the DGIIN, ÖGIAIN and DIVI. Medizinische Klinik - Intensivmedizin und Notfallmedizin, 113(5), 358-369. https://dx.doi.org/10.1007/s00063-018-0413-2

MLA:
Joannidis, M., et al. "Prevention of acute kidney injury in critically ill patients : Recommendations from the renal section of the DGIIN, ÖGIAIN and DIVI." Medizinische Klinik - Intensivmedizin und Notfallmedizin 113.5 (2018): 358-369.

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Last updated on 2018-12-11 at 11:08