2025 Multiprofessional Critical Care Review: Adult Online-Acute Kidney Injury and Renal Replacement Therapy

Video Transcription

Video Summary

This lecture covers acute kidney injury (AKI) diagnosis, management, and renal replacement therapy (RRT). Using the KDIGO criteria, AKI stages are defined by urine output duration and creatinine increase. Initial management focuses on fluid resuscitation with balanced crystalloids guided by clinical assessment and imaging. The SMART and SALT-ED trials suggest balanced fluids may reduce major adverse kidney events compared to normal saline, though evidence isn’t definitive. AKI causes include sepsis, nephrotoxins, and cardiogenic or hepatorenal syndromes. Contrast-induced AKI remains controversial, with precautions recommended for high-risk patients. Antibiotics like vancomycin can contribute to AKI, requiring careful monitoring. Indications for RRT include refractory acidosis, hyperkalemia, volume overload, and worsening renal function. Timing studies (AKIKI, IDEAL ICU) show no mortality difference between early and delayed RRT initiation, guiding individualized decisions based on illness severity and trajectory. Continuous RRT is preferred in hemodynamically unstable or neurologically vulnerable patients, while intermittent hemodialysis suits toxin clearance and stable patients.

Meta Tag

Concept Acute Kidney Injury

Concept Renal Replacement Therapy

Concept KDIGO Criteria

Concept AKI Staging

Concept Fluid Resuscitation

Keywords

acute kidney injury

KDIGO criteria

renal replacement therapy

fluid resuscitation

balanced crystalloids

contrast-induced AKI

Acute Kidney Injury

Renal Replacement Therapy

KDIGO Criteria

AKI Staging

Fluid Resuscitation

	Society of Critical Care Medicine 500 Midway Drive Mount Prospect, IL 60056 USA Phone: +1 847 827-6888 Fax: +1 847 439-7226 Email: support@sccm.org	Contact Us About SCCM Newsroom Advertising & Sponsorship DONATE	MySCCM LearnICU Patients & Families Surviving Sepsis Campaign Critical Care Societies Collaborative	GET OUR NEWSLETTER
© Society of Critical Care Medicine. All rights reserved. \| Privacy Statement \| Terms & Conditions The Society of Critical Care Medicine, SCCM, and Critical Care Congress are registered trademarks of the Society of Critical Care Medicine.