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Emerg Med Clin North Am. 2019 Aug;37(3):459-471. doi: 10.1016/j.emc.2019.04.006. Epub 2019 May 24.

Emergency Department Management of Acute Kidney Injury, Electrolyte Abnormalities, and Renal Replacement Therapy in the Critically Ill.

Author information

1
Department of Emergency Medicine, University of Michigan Health System, 1500 East Medical Center Drive SPC 5301, Ann Arbor, MI 48109, USA; Department of Internal Medicine, Division of Pulmonary Critical Care, University of Michigan Health System, 1500 East Medical Center Drive SPC 5301, Ann Arbor, MI 48109, USA. Electronic address: coivan@med.umich.edu.
2
Department of Emergency Medicine, Division of Emergency Critical Care, Massey Family Foundation Emergency Critical Center (EC3), University of Michigan Health System, 1500 East Medical Center Drive, Ann Arbor, MI 48109-5303, USA; Department of Anesthesiology, Division of Emergency Critical Care, Massey Family Foundation Emergency Critical Center (EC3), University of Michigan Health System, 1500 East Medical Center Drive, Ann Arbor, MI 48109-5303, USA; Department of Internal Medicine, Division of Emergency Critical Care, Massey Family Foundation Emergency Critical Center (EC3), University of Michigan Health System, 1500 East Medical Center Drive, Ann Arbor, MI 48109-5303, USA.

Abstract

Acute kidney injury (AKI) is a common sequela of critical illness. Clinical manifestation of AKI varies and can include electrolyte abnormalities, anion gap, or non-anion-gap metabolic acidosis. Treatment strategies require careful identification of the cause of the AKI, relying on both clinical history and laboratory data. Once the cause has been identified, treatment can then target the underlying cause and avoid further insults. Conservative management should first be attempted for patients with AKI. If conservative management fails, renal replacement therapy or hemodialysis can be used.

KEYWORDS:

Acidosis; Acute kidney injury; Acute renal failure; Electrolyte derangement

PMID:
31262415
DOI:
10.1016/j.emc.2019.04.006
[Indexed for MEDLINE]

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