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Defining acute renal failure: physiological principles

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Abstract

Definitions are never “right” or “wrong”. They are simply more or less “useful” for a given purpose. The same is true of the clinical syndrome of acute renal failure (ARF), which is common in the ICU [1, 2]. In many ways, its nature and epidemiology resemble those of other loosely defined ICU syndromes, such as sepsis or ARDS. In this physiological note, however, we wish to focus on how our understanding of renal physiology can be used to guide the definition of ARF.

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References

  1. De Mendonca A, Vincent J-L, Suter PM et al. (2000) Acute renal failure in the ICU: risk factors and outcome evaluated by the SOFA score. Intensive Care Med 26:915–921

    Article  PubMed  Google Scholar 

  2. Chertow GM, Levy EM, Hammermeister KE, Grover F, Daley J (1998) Independent association between acute renal failure and mortality following cardiac surgery. Am J Med 104:343–348

    Article  PubMed  CAS  Google Scholar 

  3. Bosch JP, Lauer A, Glabman S (1984) Short-term protein loading in assessment of patients with renal disease. Am J Med 77:873–879

    Article  PubMed  CAS  Google Scholar 

  4. Bosch JP, Saccaggi A, Lauer A, Ronco C, Belledonne M, Glabman S (1983) Renal functional reserve in humans. Effect of protein intake on glomerular filtration rate. Am J Med 75:943–950

    Article  PubMed  CAS  Google Scholar 

  5. Bosch JP, Lew S, Glabman S, Lauer A (1986) Renal hemodynamic changes in humans. Response to protein loading in normal and diseased kidneys. Am J Med 81:809–815

    Article  PubMed  CAS  Google Scholar 

  6. Ronco C, Brendolan A, Bragantini L, Chiaramonte S, Fabris A, Feriani M, Dell Aquila R, Milan M, Mentasti P, La Greca G (1988) Renal functional reserve in pregnancy. Nephrol Dial Transplant 3:157–161

    PubMed  CAS  Google Scholar 

  7. Levey AS (1990) Measurement of renal function in chronic renal disease. Kidney Int 38:167–173

    PubMed  CAS  Google Scholar 

  8. Perrone RD, Madias NE, Levey AS (1992) Serum creatinine as an index of renal function: new insights into old concepts. Clin Chem 38:1933–1953

    PubMed  CAS  Google Scholar 

  9. Clark WR, Ronco C (1998) Renal replacement therapy in acute renal failure: solute removal mechanisms and dose quantification. Kidney Int (Suppl) 53:S133–S137

    Google Scholar 

  10. Doolan PD, Alpen EL, Theil GB (1962) A clinical appraisal of the plasma concentration and endogenous clearance of creatinine. Am J Med 32:65–72

    Article  PubMed  CAS  Google Scholar 

  11. Kim KE, Onesti G, Ramirez O (1969) Creatinine clearance in renal disease. A reappraisal. BMJ 4:11–19

    Article  PubMed  CAS  Google Scholar 

  12. Branstrom E, Grzegorczyk A, Jacobsson L (1998) GFR measurement with iohexol and 51Cr-EDTA. A comparison of the two favoured GFR markers in Europe. Nephrol Dial Transplant 13:1176–1181

    Article  Google Scholar 

  13. Han WK, Bailly V, Abichandani R et al. (2002) Kidney injury molecule-1 (KIM-1): a novel biomarker for human renal proximal tubule injury. Kidney Int 62:237–244

    Article  PubMed  CAS  Google Scholar 

  14. Jovanovic D, Krstivojevic P, Obradovic I, Durdevic V, Dukanovic L (2003) Serum cystatin C and beta2-microglobulin as markers of glomerular filtration rate. Ren Fail 25:123–133

    Article  PubMed  CAS  Google Scholar 

  15. Herget-Rosenthal S, Marggraf G, Goering F, Phillip T, Kribben A (2003) Can serum cystatin C detect acute renal failure? (abstract). ISN-ERA/EDTA World Congress of Nephrology, Berlin:O11

    Google Scholar 

  16. Fliser D, Franek E, Joest M et al (1997) Renal function in the elderly: impact of hypertension and cardiac function. Kidney Int 51:1196–1204

    Article  PubMed  CAS  Google Scholar 

  17. National Kidney Foundation. K/DOQI (2002) Clinical practice guidelines for chronic kidney disease; evaluation, classification and stratification. Am J Kidney Dis (Suppl) 39:S76–S92

    Google Scholar 

  18. Bellomo R, Kellum J, Ronco C (2001) Acute renal failure: time for consensus. Intensive Care Med 27:1685–1688

    Article  PubMed  CAS  Google Scholar 

  19. Kellum JA, Mehta RL, Ronco C (2001) Acute dialysis quality initiative (ADQI). Contrib Nephrol 132:258–265

    Article  PubMed  Google Scholar 

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© 2006 Springer-Verlag Berlin Heidelberg

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Bellomo, R., Kellum, J.A., Ronco, C. (2006). Defining acute renal failure: physiological principles. In: Applied Physiology in Intensive Care Medicine. Springer, Berlin, Heidelberg. https://doi.org/10.1007/3-540-37363-2_19

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  • DOI: https://doi.org/10.1007/3-540-37363-2_19

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-37361-2

  • Online ISBN: 978-3-540-37363-6

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