Ostermann Marlies, Joannidis Michael, Pani Antonello, Floris Matteo, De Rosa Silvia, Kellum John A, Ronco Claudio
Department of Nephrology and Critical Care, Guy's and St. Thomas' Hospital, London, UK.
Blood Purif. 2016;42(3):224-37. doi: 10.1159/000448506. Epub 2016 Aug 26.
When and in whom to initiate continuous renal replacement therapy (CRRT) for acute kidney injury (AKI) remains a highly controversial topic with large practice variation around the world. Even within countries, practice variation exists and recommendations for clinical practice are not specific. In this article, we report the consensus recommendations for timing and patient selection for CRRT - the results of the 2016 Acute Disease Quality Initiative XVII conference on 'precision CRRT'. We suggest that these recommendations could serve to develop the best clinical practice and standards of care for use of CRRT in patients with AKI. Finally, we identify and highlight the areas of ongoing uncertainty and propose an agenda for future research.
对于急性肾损伤(AKI)患者,何时以及对何人开始进行持续肾脏替代治疗(CRRT)仍是一个极具争议的话题,全球范围内的实践差异很大。即使在各国国内,实践差异也存在,且临床实践建议并不具体。在本文中,我们报告了关于CRRT时机选择和患者挑选的共识性建议——2016年第十七届急性疾病质量改进会议关于“精准CRRT”的会议结果。我们认为,这些建议有助于制定针对AKI患者使用CRRT的最佳临床实践和护理标准。最后,我们识别并强调了仍存在不确定性的领域,并提出了未来研究议程。