Severe acute kidney injury in the intensive care unit: step-to-step management
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Severe acute kidney injury in the intensive care unit: step-to-step management
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This review article examines the management of severe acute kidney injury (AKI) for patients within the intensive care unit, particularly those experiencing fluid overload. The authors outline a step-by-step clinical approach that begins with identifying reversible causes and confirming congestion through point-of-care ultrasound. Initial treatment focuses on pharmacological strategies, primarily utilizing loop diuretics and addressing potential diuretic resistance through combination therapies or hemodynamic optimization. If medical interventions fail, the text provides detailed guidance on implementing continuous renal replacement therapy (CRRT), including timing, dosing, and anticoagulation. Finally, the source addresses the complications associated with dialysis and the specific criteria used to determine when a patient can be successfully weaned from treatment.
https://drive.google.com/file/d/1tmBU8y4R7KQ0z-yEovgWAIt44RJFCms0/view?usp=sharing
Mauro Riccardi, Matteo Pagnesi, Carlo M Lombardi, Marco Metra, Severe acute kidney injury in the intensive care unit: step-to-step management, European Heart Journal. Acute Cardiovascular Care, Volume 14, Issue 10, October 2025, Pages 618–630, https://doi.org/10.1093/ehjacc/zuaf084