Reducing Mortality in Acute Kidney Injury

201 Pages·2016·4.93 MB·English

by  Giovanni Landoni

Reducing
Mortality in Acute
Kidney Injury
Giovanni Landoni
Antonio Pisano
Alberto Zangrillo
Rinaldo Bellomo
Editors
123
Reducing Mortality in Acute Kidney Injury

Giovanni Landoni (cid:129) Antonio Pisano
Alberto Zangrillo (cid:129) Rinaldo Bellomo
Editors
Reducing Mortality
in Acute Kidney Injury
Editors
Giovanni Landoni Alberto Zangrillo
Dept of Anesthesia & Intensive care Dept of Anesthesia & Intensive care
IRCCS San Raffaele Scientifi c Institute IRCCS San Raffaele Scientifi c Institute
Milano Milano
Italy Italy
Antonio Pisano Rinaldo Bellomo
Cardiac Anesthesia & ICU Austin Hospital
AORN Dei Colli, Monaldi Hospital Heidelberg
Naples Victoria
Italy Australia
ISBN 978-3-319-33427-1 ISBN 978-3-319-33429-5 (eBook)
DOI 10.1007/978-3-319-33429-5
Library of Congress Control Number: 2016946426
© Springer International Publishing Switzerland 2016
T his work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of
the material is concerned, specifi cally the rights of translation, reprinting, reuse of illustrations, recitation,
broadcasting, reproduction on microfi lms or in any other physical way, and transmission or information
storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology
now known or hereafter developed.
T he use of general descriptive names, registered names, trademarks, service marks, etc. in this publication
does not imply, even in the absence of a specifi c statement, that such names are exempt from the relevant
protective laws and regulations and therefore free for general use.
T he publisher, the authors and the editors are safe to assume that the advice and information in this book
are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the
editors give a warranty, express or implied, with respect to the material contained herein or for any errors
or omissions that may have been made.
Printed on acid-free paper
This Springer imprint is published by Springer Nature
The registered company is Springer International Publishing AG Switzerland
Pref ace
Acute kidney injury (AKI) carries a heavy burden of morbidity and mortality in any
clinical setting. In particular, AKI represents a big deal for surgeons, anesthesiolo-
gists, and intensivists worldwide, since it may occur in more than a third of patients
undergoing major surgery and in up to two thirds of intensive care unit (ICU)
patients, especially those with sepsis. Furthermore, AKI is relatively common in
many other clinical situations including liver disease, hematologic malignancies,
and exposure to contrast media. Accordingly, other specialists such as gastro-
enterologists, hematologists, radiologists, and interventional cardiologists have to
take care of AKI in their daily clinical practice.
A KI reduces patients’ quality of life, increases hospital length of stay and care
costs, it may progress towards chronic kidney disease and, above all, it increases
both short- and long-term mortality. In patients undergoing major surgery, for
example, AKI is associated with an almost fourfold increase in 90-day mortality,
while mortality rate is more than doubled in ICU patients with any stage of AKI and
it may reach 60% in those requiring renal replacement therapy (RRT).
Unfortunately, so far very few interventions have been clearly proven to be effec-
tive in preventing either AKI or its progression towards the need for RRT or end-
stage renal failure requiring “chronic” hemodialysis. A review of the best-quality
and widely agreed evidence about the therapeutic interventions (drugs, techniques,
and strategies) that may affect mortality in patients with or at risk for AKI was
recently achieved using an innovative, web-based consensus process. This “democ-
racy-based” approach has been already applied to the identifi cation of all interven-
tions which may infl uence mortality in other clinical settings such as the perioperative
period of any adult surgery and critical care.
Like “R educing Mortality in the Perioperative Period ” and “R educing Mortality
in Critically Ill Patients, ” this third book explores in detail all the identifi ed inter-
ventions which could be implemented (or avoided) in order to reduce mortality in
patients with or at risk for AKI. The covered topics range from all aspects of renal
replacement therapy (modality, intensity, timing, anticoagulation) to drugs or strate-
gies which have proven to be effective in preventing or treating AKI in various clini-
cal settings (cirrhosis, sepsis, multiple myeloma, angiography, surgery, burns) to
those therapeutic approaches (loop diuretics, hydroxyethyl starches, fl uid overload)
which could cause or aggravate AKI. Every chapter deals with an individual drug,
technique, or strategy and it is structured in: background knowledge, main evidence
v
vi Preface
from literature, and a practical how-to-do section. We also briefl y describe the inno-
vative consensus process that gave strength to our systematic review.
We thank all the hundreds of colleagues from all over the world who spent their
time to help us in this consensus building process and the prestigious international
authors who wrote the 22 chapters of this book. We hope that it may represent a
signifi cant contribution to spread the awareness of acute kidney injury as a major
medical issue, to help clinicians in making therapeutic choices which may hope-
fully improve survival of their patients and, fi nally, to give useful hints for future
research.
Milan , Italy Giovanni Landoni
Naples , Italy Antonio Pisano
Milan , Italy Alberto Zangrillo
Heidelberg , Australia Rinaldo Bellomo
Contents
Part I Introduction
1 Acute Kidney Injury: The Plague of the New Millennium . . . . . . . . . . . 3
Zaccaria Ricci and Claudio Ronco
2 Acute Kidney Injury: Definitions, Incidence, Diagnosis,
and Outcome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Francis X. Dillon and Enrico M. Camporesi
3 Reducing Mortality in Acute Kidney Injury:
The Democracy-Based Approach to Consensus . . . . . . . . . . . . . . . . . . . 33
Massimiliano Greco , Margherita Pintaudi , and Antonio Pisano
Part II Interventions That May Reduce Mortality
4 Continuous Renal Replacement Therapy Versus Intermittent
Haemodialysis: Impact on Clinical Outcomes . . . . . . . . . . . . . . . . . . . . 43
Johan Mårtensson and Rinaldo Bellomo
5 May an “Early” Renal Replacement Therapy
Improve Survival? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
Giacomo Monti , Massimiliano Greco , and Luca Cabrini
6 Increased Intensity of Renal Replacement Therapy
to Reduce Mortality in Patients with Acute Kidney Injury . . . . . . . . . 59
Zaccaria Ricci and Stefano Romagnoli
7 Citrate Anticoagulation to Reduce Mortality in Patients Needing
Continuous Renal Replacement Therapy . . . . . . . . . . . . . . . . . . . . . . . . 67
Massimiliano Greco , Giacomo Monti , and Luca Cabrini
8 Peri-angiography Hemofiltration to Reduce Mortality . . . . . . . . . . . . . 73
Giancarlo Marenzi , Nicola Cosentino , and Antonio L. Bartorelli
9 Continuous Venovenous Hemofiltration to Reduce Mortality
in Severely Burned Patients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81
Kevin K. C hung
vii
viii Contents
10 Perioperative Hemodynamic Optimization to Reduce Acute Kidney
Injury and Mortality in Surgical Patients . . . . . . . . . . . . . . . . . . . . . . . 87
Nicola Brienza , Mariateresa Giglio , and Argentina Rosanna Saracco
11 Furosemide by Continuous Infusion to Reduce Mortality
in Patients with Acute Kidney Injury . . . . . . . . . . . . . . . . . . . . . . . . . . . 95
Michael Ibsen and Anders Perner
12 N-acetylcysteine to Reduce Mortality in Cardiac Surgery . . . . . . . . . 101
Matteo Parotto and Duminda N. Wijeysundera
13 Fenoldopam and Acute Kidney Injury: Is It Time
to Turn the Page? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107
Antonio Pisano , Nicola Galdieri , and Antonio Corcione
14 Vasopressin to Reduce Mortality in Patients with
Septic Shock and Acute Kidney Injury . . . . . . . . . . . . . . . . . . . . . . . . . 113
Linsey E. Christie and Michelle A. Hayes
15 Terlipressin Reduces Mortality in Hepatorenal Syndrome . . . . . . . . . 121
Rakhi Maiwall and S hiv Kumar Sarin
16 Albumin to Reduce Mortality in Cirrhotic Patients
with Acute Kidney Injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133
Christian J. Wiedermann
17 Extracorporeal Removal of Serum-Free Light Chains in Patients
with Multiple Myeloma-Associated Acute Kidney Injury . . . . . . . . . 143
Gianluca P aternoster , Paolo Fabbrini , and Imma Attolico
18 Can Intravenous Human Immunoglobulins Reduce Mortality
in Patients with (Septic) Acute Kidney Injury? . . . . . . . . . . . . . . . . . . 149
Lisa Mathiasen , Roberta Maj , and Gianluca Paternoster
Part III Interventions That May Increase Mortality
19 Fluid Overload May Increase Mortality in Patients
with Acute Kidney Injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157
Ken Parhar and Vasileos Zochios
20 Hydroxyethyl Starch, Acute Kidney Injury, and Mortality . . . . . . . . 163
Christian J. Wiedermann
21 Loop Diuretics and Mortality in Patients
with Acute Kidney Injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 175
Łukasz J. Krzych and Piotr Czempik
Contents ix
Part IV Update
22 Reducing Mortality in Patients with Acute Kidney Injury:
A Systematic Update . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 187
Marta Mucchetti , Federico Masserini , and Luigi Verniero
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 199