Stellenwert adjuvanter Therapien des akuten Nierenversagens

Abstract

Summary Adjuvant therapeutic strategies in patients with acute. renal failure are part of high quality intensive care management. They have to include preventive as well as therapeutic aspects, especially careful hemodynamic monitoring and optimization of the often deranged fluid balance. Nephrotoxic substances (e.g., radiocontrast agents, aminoglycosides, nonsteroidal antiinflammatory drugs) should be avoided or at least scrutinized. The vaspressor of choice is epinephrine. High-dose loop diuretics should be used cautiously in critically ill patients with acute renal failure. The medical standard also comprises adequate nutrition and subsequent correction of an elevated blood glucose level. It is a challenge to recognize complications early, to prevent or to treat them adequately. Sick and complex hospitalized patients offer ample opportunity for a collaborative interaction between the intensivist and the nephrologist in an intensive care unit.