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Medizinische Klinik - Intensivmedizin und Notfallmedizin

Erschienen in:

15.03.2018 | Notfallmedizin | Leitlinien und Empfehlungen

Extrakorporale Nierenersatztherapie bei akuter Nierenschädigung

Empfehlungen der Sektionen „Niere“ der DGIIN, ÖGIAIN und DIVI

verfasst von: Prof. Dr. V. Schwenger, D. Kindgen-Milles, C. Willam, A. Jörres, W. Druml, D. Czock, S. J. Klein, M. Oppert, M. Schmitz, J. T. Kielstein, A. Zarbock, M. Joannidis, S. John

Erschienen in: Medizinische Klinik - Intensivmedizin und Notfallmedizin | Ausgabe 5/2018

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Zusammenfassung

Hintergrund

Eine akute Nierenschädigung ist bei Intensivpatienten mit bis zu über 50 % eine häufige Komplikation, die mit hoher Morbidität, Mortalität und schlechter Langzeitprognose assoziiert ist. Bei 5–25 % dieser Patienten mit akuter Nierenschädigung auf der Intensivstation ist eine Nierenersatztherapie notwendig. Es stehen hierfür unterschiedliche Nierenersatzverfahren zur Verfügung.

Ziel der Arbeit

Um Indikation, Zeitpunkt, Auswahl und Anwendung der Nierenersatztherapie beim Erwachsenen zu erleichtern, werden aktuelle Empfehlungen der Sektionen Niere der Deutschen Gesellschaft für Internistische Intensivmedizin und Notfallmedizin (DGIIN), der Österreichischen Gesellschaft für Internistische und Allgemeine Intensivmedizin und Notfallmedizin (ÖGIAIN) und der Deutschen Interdisziplinären Vereinigung für Intensiv- und Notfallmedizin (DIVI) dargestellt.

Material und Methoden

Die Empfehlungen dieser Arbeit basieren auf den aktuellen KDIGO(Kidney Disease: Improving Global Outcomes)-Leitlinien, den Empfehlungen der 17th Acute Disease Quality Initiative (ADQI)/Consensus Group der Französischen Intensivmedizinischen Fachgesellschaften (SRLF, SFAR) und der Expertenmeinung und klinischer Erfahrung der Autoren.

Ergebnisse

Kontinuierliche Verfahren unterscheiden sich hinsichtlich der Mortalität nicht von intermittierenden oder verlängerten Dialyseverfahren, weisen aber Unterschiede in der Handhabung und Ökonomie auf. Eine individualisierte Risikostratifizierung bezüglich des Behandlungsbeginns und der Verfahrenswahl sollte erfolgen.

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Titel: Extrakorporale Nierenersatztherapie bei akuter Nierenschädigung
Empfehlungen der Sektionen „Niere“ der DGIIN, ÖGIAIN und DIVI
verfasst von: Prof. Dr. V. Schwenger
D. Kindgen-Milles
C. Willam
A. Jörres
W. Druml
D. Czock
S. J. Klein
M. Oppert
M. Schmitz
J. T. Kielstein
A. Zarbock
M. Joannidis
S. John
Publikationsdatum: 15.03.2018
Verlag: Springer Medizin
Schlagwörter: Notfallmedizin
Autopsie
Akutes Nierenversagen
Nierenersatzverfahren
Hämofiltration
Akutes Nierenversagen
Erschienen in: Medizinische Klinik - Intensivmedizin und Notfallmedizin / Ausgabe 5/2018
Print ISSN: 2193-6218
Elektronische ISSN: 2193-6226
DOI: https://doi.org/10.1007/s00063-018-0418-x

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Extrakorporale Nierenersatztherapie bei akuter Nierenschädigung

Empfehlungen der Sektionen „Niere“ der DGIIN, ÖGIAIN und DIVI