Journal
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
Volume 76, Issue 9, Pages 1084-1101Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jacc.2020.06.070
Keywords
acute kidney injury; cardiorenal syndrome; dialysis; heart failure; hemofiltration; renal replacement therapy; ultrafiltration
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Funding
- Intramural Research Program of the National Institutes of Health Clinical Center
- Baxter
- NxStage
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Acute kidney injury (AKI) and cardiorenal syndrome (CRS) are increasingly prevalent in hospitalized patients with cardiovascular disease and remain associated with poor shortand long-term outcomes. There are no specific therapies to reduce mortality related to either AKI or CRS, apart from supportive care and volume status management. Acute renal replacement therapies (RRTs), including ultrafiltration, intermittent hemodialysis, and continuous RRT are used to manage complications of medically refractory AKI and CRS and may restore normal electrolyte, acid-base, and fluid balance before renal recovery. Patients who require acute RRT have a significant risk of mortality and long-term dialysis dependence, emphasizing the importance of appropriate patient selection. Despite the growing use of RRT in the cardiac intensive care unit, there are few resources for the cardiovascular specialist that integrate the epidemiology, diagnostic workup, and medical management of AKI and CRS with an overview of indications, multidisciplinary team management, and transition off of RRT. (c) 2020 the American College of Cardiology Foundation. Published by Elsevier. All rights reserved.
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