Acute renal failure in critical care, what Intensivists need to know

Summary

In the session on Acute Renal Failure and Renal Replacement Therapy (RRT) Therapy by Ahmed M. Sarhan, MBBCh, MSc, MRCP (UK), ACCP fellowship (USA), medical professionals will explore the critical elements of renal failure, particularly in the Intensive Care Unit (ICU). Dive into a case study of a 55-year-old patient admitted with Acute Severe Pancreatitis, rising creatinine and deteriorating kidney functions. Unravel possible causes, diagnosis methods and decide whether it's acute, chronic, or A/C. Understand the need for nephrology consultation or ICU admission. The session also covers therapy options including RRT Therapy, discussing hemodialysis or peritoneal dialysis, types of RRT, anticoagulation, and citrate toxicity. This is a unique opportunity to sharpen your knowledge and skills in treating renal failure and effectively applying RRT Therapy in an ICU setting.

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Description

The webinar on Acute Renal Failure in Critical Care covers essential insights for intensivists, including early detection methods, key diagnostic criteria, and effective management strategies. It emphasizes the importance of understanding the pathophysiology, monitoring renal function, and implementing timely interventions to improve patient outcomes in critical care settings.

None of the planners for this educational activity have relevant financial relationship(s) to disclose with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

Dr. Sarhan, faculty for this educational event, has no relevant financial relationship(s) with ineligible companies to disclose.

Learning objectives

Understand the potential causes and indicators of acute renal failure in patients with complex, multiple conditions such as alcoholism, pancreatitis and heart failure.
Differentiate between acute and chronic kidney failure, and acute on chronic, based on patient symptoms, medical history, and test results.
Diagnose and manage acute renal failure in an ICU or similar high-acuity environment, including decisions about fluid and diuretic administration.
Determine the appropriate role of interdisciplinary collaboration in managing acute renal failure, including when to consult nephrology specialists and when to involve an ICU team.
Apply knowledge of renal replacement therapy (RRT) options to individual patient scenarios, considered in terms of patient needs, desired outcomes, and possible risks. This includes dialysis choices, venous access, filtration methods, intensity of CRRT, and anticoagulation implications.

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ACUTE RENAL FAILURE RRT THERAPY , WHAT WE NEED TO KNOW IN ICU Ahmed M. Sarhan MBBCh, MSc, MRCP (UK), ACCP fellowship (USA) William, 55 ys old, known alcoholic liver disease, D3 hospital admission with Acute severe pancreatitis ( CT abdomen C+) on admission, started piperacillin/ tazobactam (rising CRP), rising creatinine 180 from 85 (4 months ago). PMH: HTN (ACEI), COPD, Right Sided Heart Failure. 1) What are possible causes of deteriorating kidney functions ? 2) Is it acute or chronic or A/C? 3) What to do? ?? Fluids ?? Diuretics 4) Should we bring nephrology on board ? 5) Should we call ICU team ?3Ds late, William was not admitted, improved creatinine , amylase, lipase numbers, abdominal pain better , Follow up CT abdomen/ pelvis showing increased free fluid in abdomen. On D20, he developed generalized abdominal distension, pain and tenderness, creatinine 300 then 400, oliguria, f, soft blood pressure, oliguric, Potassium 6 mmol/l, ABG pH 7.28/pCo 2 10/pO210/HCO 322/ 91% on VM 0.4 % 10 L, albumin 2, Lactate 6, Na 128, Cl 93, non tolerating his feeding. 2) What are possible causes? ABG secrets ?? CT A/P C+ 3) What to do? 4) Do we need ICU admission? RRT?1.Is it same contrast?? 2.Evidence? 3.Is creatinine a good marker of kidney injury? 4.Pseudonephrotoxin 5.How much is severe the injury? 6.Renalism RRT Haemo or peritoneal ?? Venous access ?? Continuous VS Intermittent VS SLED?? Dialysis/ Filtration/ Diafiltration?? CRRT High vs lower intensity?? Anticoagulation?? Citrate toxicity.THANK YOU