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Intensive Care Medicine
Erschienen in: Intensive Care Medicine 12/2008

01.12.2008 | Review

Renal replacement therapies: physiological review

verfasst von: Claudio Ronco, Zaccaria Ricci

Erschienen in: Intensive Care Medicine | Ausgabe 12/2008

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Abstract

Introduction

A physiological review on renal replacement therapies (RRT) is a challenging task: there is nothing "physiologic" about RRT, since the most accurate, safe and perfectly delivered extracorporeal therapy would still be far from "physiologically" replacing the function of the native kidney.

Methods

This review will address the issues of physiology of fluid and solute removal, acid base control and impact on mortality during intermittent and continuous therapies: different RRT modalities and relative prescriptions will provide different "physiological clinical effects" to critically ill patients with acute kidney injury (AKI), with the aim of restoring lost "renal homeostasis". On the other side, however, the "pathophysiology" of RRT, consists with unwanted clinical effects caused by the same treatments, generally under-recognized by current literature but often encountered in clinical practice. Physiology and pathophysiology of different RRT modalities have been reviewed.

Conclusion

Physiology and pathophysiology of RRT often coexist during dialysis sessions. Improvement in renal recovery and survival from AKI will be achieved from optimization of therapy and increased awareness of potential benefits and dangers deriving from different RRT modalities.
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Metadaten
Titel
Renal replacement therapies: physiological review
verfasst von
Claudio Ronco
Zaccaria Ricci
Publikationsdatum
01.12.2008
Verlag
Springer-Verlag
Erschienen in
Intensive Care Medicine / Ausgabe 12/2008
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-008-1258-6

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