Cardiorenal Syndromes in Critical Care ( Contributions to Nephrology )

Publication series : Contributions to Nephrology

Author: Ronco C.; Bellomo R.; McCullough P.A.  

Publisher: S. Karger AG‎

Publication year: 2010

E-ISBN: 9783805594738

P-ISBN(Paperback): 9783805594721

Subject: Q5 Biochemistry;R47 Nursing;R5 Internal Medicine;R54 in cardiac and vascular diseases (circulatory system);R56 Respiratory and thoracic diseases;R69 urological (genito - urinary diseases)

Keyword: 生物化学,护理学,呼吸系及胸部疾病,泌尿科学(泌尿生殖系疾病),内科学,心脏、血管(循环系)疾病

Language: ENG

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Description

Critical care nephrology is an emerging multidisciplinary science in which the competences of different specialists are merged to provide a unified diagnostic and therapeutic approach to the critically ill patient. The volume at hand places great emphasis on cardiorenal syndromes and the multidisciplinary collaboration between cardiology and nephrology. Several contributions describe the cardiorenal syndrome in its different varieties and subtypes and report the results from the most recent Acute Dialysis Quality Initiative Consensus Conference, as well as proposing new diagnostic approaches based on early biomarkers of AKI. Other papers discuss advances in technology for renal replacement therapy and multiple organ support therapy. Moreover, special emphasis is placed on the potential role of extracorporeal therapies in patients affected by H1N1 influenza, and a summary of the most recent trials in the field is included.Containing the proceedings of the 2010 International Vicenza Course on Critical Care Nephrology, this publication is a state-of-the-art appraisal of today’s technology and current issues related to cardiorenal syndromes.

Chapter

Pathophysiology of Acute Kidney Injury

Pathophysiology of AKI: Injury and Normal and Abnormal Repair

Abstract

Vasculature Reactivity

Endothelium

Inflammation

Normal Repair of the Epithelium

Abnormal Repair of the Epithelium

Conclusions

Acknowledgment

References

Pathophysiology of Septic Acute Kidney Injury: A Different View of Tubular Injury

Abstract

The Ischemia Paradigm

Histopathological Changes in Septic AKI

Apoptosis of Kidney Tubules in Septic AKI

Role of Toll-Like Receptors

Mitochondrial Dysfunction and ATP Depletion

Conclusions

References

Cardiopulmonary Bypass, Hemolysis, Free Iron, Acute Kidney Injury and the Impact of Bicarbonate

Abstract

References

Acute Kidney Injury and Cardiopulmonary Bypass: Special Situation or Same Old Problem?

Abstract

General Pathophysiology

Antifibrinolytics

Hemolysis

Blood Pressure

Conclusions

References

Pathophysiology of Acute Kidney Injury: A New Perspective

Abstract

Renal Response Following Injury

Renal Tubular Inflammation and Repair

Important Elements that Mediate Injury Responses and Recovery

Potential Immune Modulation Therapies for AKI

Conclusion

References

Multiphoton Imaging Techniques in Acute Kidney Injury

Abstract

Multiphoton Microscopy

Intracellular Endocytosis, Trafficking, Transcytosis

Glomerular Permeability

Proximal Tubule Reabsorption

Red Blood Cell Flow Rates

Inflammation and Leukocytes

Vascular Pathology

Conclusion

References

Cardiorenal Syndromes

Cardiorenal Syndromes: An Executive Summary from the Consensus Conference of the Acute Dialysis Quality Initiative (ADQI)

Abstract

Cardiorenal Syndrome Type 1 (Acute Cardiorenal Syndrome)

Cardiorenal Syndrome Type 2 (Chronic Cardiorenal Syndrome)

Cardiorenal Syndrome Type 3 (Acute Renocardiac Syndrome)

Cardiorenal Syndrome Type 4 (Chronic Renocardiac Syndrome)

Cardiorenal Syndrome Type 5 (Secondary Cardiorenal Syndrome)

Conclusions

References

Epidemiology of Cardiorenal Syndromes

Abstract

Acute Cardiorenal Syndrome (Type 1 CRS)

Chronic Cardiorenal Syndrome (Type 2 CRS)

Acute Reno-Cardiac Syndrome (Type 3 CRS)

Chronic Reno-Cardiac Syndrome (Type 4 CRS)

Secondary Cardiorenal Syndromes (Type 5 CRS)

Conclusions

Acknowledgements

References

Biomarkers of Cardiac and Kidney Dysfunction in Cardiorenal Syndromes

Abstract

Natriuretic Peptides

Novel Renal Biomarkers for Cardiorenal Syndrome

Conclusion

References

How to Manage Cardiorenal Syndromes in the Emergency Room

Abstract

Acute Kidney Injury: Definition, Classification and Epidemiology

Cardiorenal Syndromes

Case Report: An Example of a Multimarker Approach in Clinical Practice

References

Prevention of Cardiorenal Syndromes

Abstract

Acute Cardiorenal Syndrome Complicating Decompensated Heart Failure

Intravenous Loop Diuretics as Precipitants of Cardiorenal Syndromes

Chronic Cardiorenal Syndrome Influencing Outpatient Heart Failure Care

Conclusions

References

Acute Heart Failure Treatment: Traditional and New Drugs

Abstract

Evaluation Phases and Aims in AHFS Patients

Treatment Options According to Blood Pressure Values

Conclusions

References

Management of Chronic Cardiorenal Syndrome

Abstract

Definitions

Management of Chronic Cardiorenal Syndrome

Management of Renal Dysfunction in Patients with Chronic Heart Failure(Summary Based on the Current Guidelines of the European Society of Cardiology – ESC)

Management of Heart Failure in Patients with Chronic Kidney Disease

Anemia in Chronic Heart and Chronic Kidney Disease

Conclusion

References

Recommended Reading

Congestion and Cardiorenal Syndromes

Abstract

Case Report

Physiology of Right Ventricular Function

Congestion and Renal Dysfunction

Conclusion

References

Cardiorenal Syndromes –Recommendations from Clinical Practice Guidelines: The Cardiologist’s View

Abstract

Patients with Acute Cardiorenal Syndrome (CRS Type 1 – Acute Worsening in Cardiac Function Leading to Acute Impairment in Renal Function)

Patients with Chronic Cardiorenal Syndrome (CRS Type 2 – Chronic Abnormalities in Cardiac Function Causing Progressive and PermanentChronic Kidney Disease)

References

Organ Crosstalk in Multiple Organ Dysfunction Syndromes

The Changing Pattern of Acute Kidney Injury: From One to Multiple Organ Failure

Abstract

AKI and Pulmonary Dysfunction

AKI and Central Nervous System Dysfunction

AKI and Cardiac Dysfunction

AKI and Liver Dysfunction

AKI and the Immune System

Distant Organ Injury following AKI: Implications for Therapy

References

The Kidney in Respiratory Failure and Mechanical Ventilation

Abstract

Acute Lung Injury and Acute Kidney Injury

Acute Lung Injury

Renal Effects of ALI and Mechanical Ventilation

Prevention and Treatment of AKI in Patients on Mechanical Ventilation

Conclusion

References

Pulmonary Renal Syndrome and Emergency Therapy

Abstract

Clinical Presentation

Laboratory Findings

Treatment

Future Therapies

References

Extracorporeal CO2 Removal – A Way to Achieve Ultraprotective Mechanical Ventilation and Lung Support: The Missing Piece of Multiple Organ Support Therapy

Abstract

Protective Lung Support and DECAP

Clinical Applications of Extracorporeal Carbon Dioxide Removal

Technical Aspects of Extracorporeal CO2 Removal

Case Report

Conclusion

References

Extracorporeal CO2 Removal

Abstract

Introduction

Extracorporeal CO2 Removal: The Concept

Extracorporeal CO2 Removal: The Clinical Data

Extracorporeal CO2 Removal: The Technological Development

Extracorporeal CO2 Removal: The Future

Conclusions

References

Management of Acute Kidney Injury in Liver Disease

Abstract

Hepatorenal Syndrome

Medical Therapy for Hepatorenal Syndrome

Surgical Management of Hepatorenal Syndrome

Renal Replacement Therapy

Renal Support Designed to Increase Hepatic Toxin Removal

Conclusion

Acknowledgement

References

Fluid Assessment and Management in the Critically Ill

Fluid Management in Septic Acute Kidney Injury and Cardiorenal Syndromes

Abstract

Pathophysiology of Fluid Therapy in Septic AKI

Adverse Effects of Fluid Therapy

Fluid Management in Cardiorenal Syndrome Types 1 and 2

Ultrafiltration

Conclusions

References

Use of Loop Diuretics in the Critically Ill

Abstract

Diuretics in the Critically Ill

Diuretics in Cardiorenal Syndromes

Conclusion

References

Use of Bioimpedance Vector Analysis in Critically Ill and Cardiorenal Patients

Abstract

Bioimpedance

Bioimpedance Vector Analysis

Conclusion

References

Extracorporeal Fluid Removal in Heart Failure Patients

Abstract

Conclusions

References

Practice of Renal Replacement Therapy in the ICU

What Is ‘BEST’ RRT Practice?

Abstract

What Is the BEST Kidney Study?

Choice of RRT Modality

Timing of RRT Initiation and Discontinuation

Practice Variations for CRRT Around the World

Conclusion

References

Anticoagulation for Renal Replacement Therapy: Different Methods to Improve Safety

Abstract

Regional Anticoagulation with Citrate

Prolonged Intermittent Renal Replacement Therapy

Conclusion

References

Renal Replacement Therapy in Adult Critically Ill Patients: When to Begin and When to Stop

Abstract

When to Begin RRT in Critically Ill Patients

Severe AKI

Mild to Moderate AKI

Extracorporeal Blood Purification for ‘Non-Renal’ Indications

Initiation of RRT: Risks vs. Benefits

When to Stop RRT

Conclusions

References

Critical Care Nephrology Issues

Urine Abnormalities in Acute Kidney Injury and Sepsis

Abstract

Epidemiology of Septic AKI

Urinary Biochemistry in Septic AKI

Urine Microscopy in Septic AKI

Histopathological Correlation in Septic AKI

Conclusions

References

Recovery from Acute Kidney Injury: Determinants and Predictors

Abstract

Why We Need to Predict Recovery of Renal Function?

Physiology of Renal Recovery

Defining Renal Recovery

Clinical Predictors of Renal Recovery

Novel Biomarkers for Predicting Renal Recovery

Conclusions

References

Dysnatremias in the Intensive Care Unit

Abstract

Epidemiology

Hyponatremia

Hypernatremia

Conclusion

References

Trials in Acute Kidney Injury

Recent Trials in Critical Care Nephrology

Abstract

The ATN Study

The RENAL Study

The SPARK Study

The IVOIRE Study

The CREAT Study

The BIC-AKI Study

CRRT in Sepsis Study

Conclusions

References

New Horizons in Critical Care Nephrology

Acute Kidney Injury and 2009 H1N1 Influenza-Related Critical Illness

Abstract

ANZ 2009 H1N1 Influenza Database

Incidence and Severity of AKI at Austin Hospital

Histopathology of 2009 H1N1 Influenza-Related AKI

Conclusions

References

Acute Kidney Injury in the Elderly: A Review

Abstract

Epidemiology of AKI in the Elderly

Factors Contributing to AKI Development in the Elderly

Etiology of AKI in the Elderly

Strategies for AKI Prevention in the Elderly

Diagnosis of AKI in the Elderly

Renal Replacement Therapy in Elderly Patients

Renal Recovery and Mortality after AKI in the Elderly

Conclusion

References

Blood Purification in Sepsis: A New Paradigm

Abstract

Changing Concepts in the Pathophysiology of Sepsis

What Does Blood Purification Do?

What Has Been Done to Improve These Technologies?

Conclusion

References

Ciné Phase-Contrast Magnetic Resonance Imaging for the Measurement of Renal Blood Flow

Abstract

Ciné Phase-Contrast MRI

Renal Blood Flow during AKI

Early Observations

Implications for Future Research

Limitations of PC-MRI Technology

Conclusions

References

The Meaning of Transient Azotemia

Abstract

Similarity of PRA and TA

Recent Studies and Systematic Reviews for PRA and ATN

The Meaning of TA

Conclusion

References

Acute Kidney Injury in the Pediatric Population

Abstract

Epidemiology, Diagnosis and Outcome

Distinctive Clinical Features of Pediatric AKI

AKI Therapy in Infants

Renal Replacement Therapy in Infants

Conclusion

References

Author Index

Subject Index

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