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Renal Replacement Therapy in Intensive Care Units.

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Presentation on theme: "Renal Replacement Therapy in Intensive Care Units."— Presentation transcript:

1 Renal Replacement Therapy in Intensive Care Units

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3 Absolute Indications of RRT in AKI (Renal Replacement Therapy) Refractory fluid overload Refractory hyperkalemia (K>6.5 meq/L) Uremic pericarditis, encephalopathy Refractory metabolic acidosis (pH < 7.1) Overdose with a dialyzable toxin/drug

4 Relative Indications of RRT in AKI (Renal Replacement Therapy ) Azotemia (urea > 80~100 mg/dL) Oliguria (urine output<200 ml/12 hr) Anuria/extreme oliguria (urine output<50 ml/12 hr) [ p.s. after proper correction of pre-renal & post-renal factors ]

5 Specialized Condition in Renal Replacement Therapy Post cardiac surgery  refractory oliguria in first 8 hrs Tumor lysis syndrome  Oliguria  Persistent hyperphosphatemia  Persistent hyperuricemia  Persistently low calcium levels

6 Unstable Hemodynamic Status Require High-dose Vasopressor in AKI - Dopamine > 20 mcg/kg/min - Norepinephrine > 0.3 mcg/kg/min and/or Absolute indications of RRT in AKI Relative Indications of RRT in AKI Specialized condition - post cardiac surgery - tumor lysis syndrome Proposed Indications for Continuous renal replacement therapy (CVVH, CVVHD, CVVHDF)


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