Das akute Nierenversagen - Nierenersatzverfahren auf der Intensivstation

Abstract

Depending on the individual definition of acute renal failure, its prevalence in intensive care units approaches 5-25 % of the cases under treatment and is associated with a definitely reduced survival rate. Hence, prevention of acute renal failure should always rank first. However, if renal replacement is nevertheless inevitable, we must definitely decide between a permanent and an intermittent procedure on the one hand and between hemodialysis and hemofiltration on the other. „Sustained low efficiency dialysis“ (SLED) during 8-12 hours is a good alternative combining the advantages of hemodialysis and continuous treatment. Hemodynamically unstable as well as definitely hyper-hydrated patients or patients suffering from hepatic insufficiency or increased intracranial pressure (e. g. skull and brain trauma) will improve in case of acute electrolytic disorders such as hyperkalemias, intoxications, hemorrhagic diathesis or in the mobilization phase. Intensive care specialists and nephrologists should individually decide which procedure would be preferable. The present article aims at assisting them.