Indian Journal of Critical Care Medicine

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2020 | April | Volume 24 | Issue S3

EDITORIAL

Ashit Hegde

Acute Kidney Injury in the Critically Ill: Herein Lies the Problem!

[Year:2020] [Month:April] [Volume:24] [Number:S3] [Pages:1] [Pages No:83 - 83]

PDF  |  DOI: 10.5005/jp-journals-10071-23413  |  Open Access |  How to cite  | 

INVITED ARTICLE

Shilpushp J Bhosale

Epidemiology and Pathogenesis of Acute Kidney Injury in the Critically Ill Patients

[Year:2020] [Month:April] [Volume:24] [Number:S3] [Pages:6] [Pages No:84 - 89]

Keywords: Acute kidney injury, Epidemiology, Incidence of acute kidney injury, Pathogenesis, Sepsis

PDF  |  DOI: 10.5005/jp-journals-10071-23394  |  Open Access |  How to cite  | 

INVITED ARTICLE

Shilpushp J Bhosale

Biomarkers in Acute Kidney Injury

[Year:2020] [Month:April] [Volume:24] [Number:S3] [Pages:4] [Pages No:90 - 93]

Keywords: Acute kidney injury, Biomarkers, Diagnosis

PDF  |  DOI: 10.5005/jp-journals-10071-23398  |  Open Access |  How to cite  | 

INVITED ARTICLE

Bindiya G Salunke

Fluid Overload and Acute Kidney Injury

[Year:2020] [Month:April] [Volume:24] [Number:S3] [Pages:4] [Pages No:94 - 97]

Keywords: Acute kidney injury, Fluid movement, Fluid overload, Renal blood flow

PDF  |  DOI: 10.5005/jp-journals-10071-23401  |  Open Access |  How to cite  | 

Abstract

Commonest intervention in hospitalized patient is fluid therapy, and practically every critically ill patient receives fluid resuscitation. Commonest indication for fluid administration is to achieve hemodynamic stability and prevent or manage acute kidney injury (AKI). However, fluid administration is a two-edged sword, i.e., inadequate fluids give rise to hypoperfusion and organ injury and overzealous fluid therapy can give rise to fluid overload and related consequences. Though fluids are commonly given to prevent development of AKI, hypervolemia itself has the potential to cause AKI.

INVITED ARTICLE

Diuretics in Acute Kidney Injury

[Year:2020] [Month:April] [Volume:24] [Number:S3] [Pages:2] [Pages No:98 - 99]

Keywords: Diuretics, Filtration, Kidney

PDF  |  DOI: 10.5005/jp-journals-10071-23406  |  Open Access |  How to cite  | 

INVITED ARTICLE

Kishore K Rajasekaran

Furosemide Stress Test in Predicting Acute Kidney Injury Outcomes

[Year:2020] [Month:April] [Volume:24] [Number:S3] [Pages:2] [Pages No:100 - 101]

Keywords: Acute kidney injury, Critical care, Furosemide

PDF  |  DOI: 10.5005/jp-journals-10071-23381  |  Open Access |  How to cite  | 

INVITED ARTICLE

Valentine Lobo

Renal Replacement Therapy in Acute Kidney Injury: Which Mode and When?

[Year:2020] [Month:April] [Volume:24] [Number:S3] [Pages:5] [Pages No:102 - 106]

Keywords: Continuous renal replacement therapy, Peritoneal dialysis, Sustained low-efficiency daily dialysis

PDF  |  DOI: 10.5005/jp-journals-10071-23383  |  Open Access |  How to cite  | 

Abstract

Renal replacement therapy (RRT) for acute kidney injury (AKI) patients in an intensive care unit (ICU) presents unique problems of providing biochemical and fluid removal in patients with unstable circulations, inotropes, and increased capillary permeability. Although no individual modality has been shown to confer a mortality benefit, it is assumed that continuous therapies like peritoneal dialysis (PD) and venovenous hemofiltration or hemodiafiltration may be better tolerated by the patient with hemodynamic instability, raised intracranial pressure (ICP), and liver failure. An individual patient may require more than one treatment in the course of his/her illness. The therapies offered may reflect available resources, local expertise, and cost constraints.

INVITED ARTICLE

Raghavan Murugan

Solute and Volume Dosing during Kidney Replacement Therapy in Critically Ill Patients with Acute Kidney Injury

[Year:2020] [Month:April] [Volume:24] [Number:S3] [Pages:5] [Pages No:107 - 111]

Keywords: Dosing, Kidney replacement therapy, Solute control, Volume control

PDF  |  DOI: 10.5005/jp-journals-10071-23391  |  Open Access |  How to cite  | 

Abstract

Among critically ill patients with severe acute kidney injury either continuous kidney replacement therapy (CKRT) or intermittent hemodialysis (IHD) can be performed to provide optimal solute and volume control. The modality of KRT should be chosen based on the needs of the patient, hemodynamic status, clinician expertise, and resource available under a particular setting and consideration of costs. Evidence from high-quality randomized trials suggests that an effluent flow rate of 25 mL/kg/hour per day using CKRT and Kt/V of 1.3 per session of IHD provide optimal solute control. For volume dosing, the net ultrafiltration (UFNET) rate should be prescribed based on patient body weight in milliliters per kilogram per hour, with close monitoring of patient hemodynamics and fluid balance. Emerging evidence from observational studies suggests a “J”-shaped association between UFNET rate and outcomes with both faster and slower UFNET rates being associated with increased mortality compared with moderate UFNET rates. Thus, randomized trials are required to determine optimal UFNET rates in critically ill patients.

INVITED ARTICLE

Simran Singh

Anticoagulation during Renal Replacement Therapy

[Year:2020] [Month:April] [Volume:24] [Number:S3] [Pages:5] [Pages No:112 - 116]

Keywords: Continuous renal replacement therapy, Low-molecular-weight heparin, Unfractionated heparin

PDF  |  DOI: 10.5005/jp-journals-10071-23412  |  Open Access |  How to cite  | 

INVITED ARTICLE

Praveen Kumar G

Extracorporeal Therapy in Sepsis

[Year:2020] [Month:April] [Volume:24] [Number:S3] [Pages:5] [Pages No:117 - 121]

Keywords: Cytokines, Endotoxin, Extracorporeal therapy, Sepsis

PDF  |  DOI: 10.5005/jp-journals-10071-23382  |  Open Access |  How to cite  | 

INVITED ARTICLE

Pratheema Ramachandran, Devachandran Jayakumar

Contrast-induced Acute Kidney Injury

[Year:2020] [Month:April] [Volume:24] [Number:S3] [Pages:4] [Pages No:122 - 125]

Keywords: Acute kidney injury, Contrast-induced acute kidney injury, Nephrotoxicity

PDF  |  DOI: 10.5005/jp-journals-10071-23379  |  Open Access |  How to cite  | 

Abstract

Contrast-induced acute kidney injury (CI-AKI) is the third common cause of kidney injury in hospitalized patients. It describes a wide spectrum of kidney injury from mild and reversible to permanent and irreversible. The mechanism of contrast-induced AKI and strategies to prevent it are not clearly understood. This review discusses the various contrast agents, pathophysiology of CI-AKI and different preventive strategies.

INVITED ARTICLE

Shilpushp J Bhosale

Preventing Perioperative Acute Kidney Injury

[Year:2020] [Month:April] [Volume:24] [Number:S3] [Pages:3] [Pages No:126 - 128]

Keywords: Acute kidney injury, Perioperative, Prevention

PDF  |  DOI: 10.5005/jp-journals-10071-23396  |  Open Access |  How to cite  | 

INVITED ARTICLE

Sai Saran, Namrata S Rao

Drug Dosing in Critically Ill Patients with Acute Kidney Injury and on Renal Replacement Therapy

[Year:2020] [Month:April] [Volume:24] [Number:S3] [Pages:6] [Pages No:129 - 134]

Keywords: Acute kidney injury, Critically ill, Drug dosing

PDF  |  DOI: 10.5005/jp-journals-10071-23392  |  Open Access |  How to cite  | 

Abstract

Acute kidney injury (AKI) complicates in around 40–50% of patients in intensive care units (ICUs), and this can account for up to 80% mortality, especially in those patients requiring renal replacement therapy (RRT). Appropriate drug dosing in such patients is a challenge to the intensivists due to various factors such as patient related (appropriate body weight, organ clearance, serum protein concentration), drug related [molecular weight (MW), protein binding, volume of distribution (Vd), hydrophilicity, or hydrophobicity], and RRT related (type, modality of solute removal, filter characteristics, dose, and duration). Therapeutic drug monitoring (TDM) of drugs can be a promising solution to this complex scenario to titrate a drug to its clinical response, but it is available only for a few drugs. In this review, we discussed drug dosing aspects of antimicrobials, sedatives, and antiepileptics in critically ill patients with AKI on RRT.

INVITED ARTICLE

Bhuvaneshwari Shankar

Nutrition Support in Critically Ill Patients with AKI

[Year:2020] [Month:April] [Volume:24] [Number:S3] [Pages:5] [Pages No:135 - 139]

Keywords: Acute kidney injury, Critical illness, Enteral nutrition, Nutrition, Parenteral nutrition

PDF  |  DOI: 10.5005/jp-journals-10071-23397  |  Open Access |  How to cite  | 

INVITED ARTICLE

Sharada Mailankody, Jyoti Bajpai, Sudeep Gupta

“Petite” p value: A Researchers’ Dream! Readers, Beware of the Pit …

[Year:2020] [Month:April] [Volume:24] [Number:S3] [Pages:2] [Pages No:140 - 141]

Keywords: Misuse, p value, Pitfalls, Statistics

PDF  |  DOI: 10.5005/jp-journals-10071-23399  |  Open Access |  How to cite  | 

Abstract

“What is the magic word for publication?” “The p value <0.05%” seems like an automatic answer from the researchers. Is that right? Let us take a quick peek at this seemingly simple gate-pass to publications!

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