ACUTE KIDNEY INJURY: THE ROLE OF HEMODIALYSIS

摘要

In veterinary medicine, dialysis is used most commonly for acute kidney injury and less frequently for chronic kidney disease. Dialysis is indicated for patients with anuria or oliguria, life threatening fluid overload (i.e., pulmonary edema), or hyperkalemia. Dialysis is generally reserved until standard medical management has been attempted. Standard medical management includes adequate volume expansion and ensuring that the systemic blood pressure is adequate to perfuse the kidneys (> 80-100 mmHgsystolic or > 60-80 mmHg mean arterial pressure). The use of diuretics is widespread in both human and veterinary medicine despite lack of conclusive evidence of a positive impact on outcome.(Bagshaw, et al. 2008) If loop diuretics, osmotic diuretics (i.e., mannitol), or other diuretics fail to induce adequate urine production within hours, early referral for dialysis is appropriate.