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S 10 Lunch Symposium

Title: Greek Workshop
Sunday, September 7, 12:30 – 14:00
Omega 2

Programme of the Session

Acute kidney injury (AKI) – renal replacement therapy
John Stefanidis, Professor of Pathology – Nephrology Director of Nephrology Clinical, University General Hospital of Larissa

Acute kidney injury (AKI) – The nursing approach

Abstract

Acute kidney injury
N. Oustampasidou, I. Stefanidis

Acute kidney injury (AKI) is an abrupt decline in kidney function. It is frequently accompanied by oligoanuria and always results in an elevation of serum urea and creatinine. Several AKI consensus meetings took place since 2004 in order to provide a uniform definition, which better represents the full spectrum of acute kidney dysfunction.
The full blown syndrome is a life-threatening condition and potential complications are volume overload, hyperkalemia, acidosis, and uremia. Treatment for these complications is renal replacement treatment by hemodialysis and its variants (intermittent or continuous) depending on the patients’ hemodynamic status.
In patients who are volume depleted fluid should be given to restore intravascular volume. The amount of fluid administered should be targeted to defined endpoints, such as arterial blood pressure or central venous (atrial) pressure. In volume overload loop diuretics should be used to relieve signs and symptoms but not for prolonged therapy in place of dialysis.
The treatment of hyperkalemia by dialysis is determined by severity (K>6 mmol/l) and by the presence of any associated symptoms or electrocardiographic signs. In severe acidosis (pH <7.1) with volume overload dialysis is preferred to the administration of bicarbonate. Bicarbonate therapy is also not recommended in less severe metabolic acidosis (pH ≥7.1).
Further optimising therapy of AKI will probably improve the bad prognosis of this severe condition.