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[重症医学中肾脏替代治疗的S3指南:危重症患者肾脏替代治疗的循证实施]

[S3 guideline on renal replacement therapy in intensive care medicine : Evidence-based implementation of renal replacement therapy in critically ill patients].

作者信息

Willam Carsten, Abu-Tair Mariam, Bayer Matthias, Bellmann Romuald, Brunkhorst Frank, Custodis Florian, Galle Jan, Hermes Carsten, Joannidis Michael, John Stefan, Jörres Achim, Kerz Thomas, Kindgen-Milles Detlef, Koczor Martin, Kram Rainer, Kuhlmann Martin K, Oppert Michael, Schlieper Georg, Schmitz Michael, Zarbock Alexander, Meersch Melanie

机构信息

Medizinische Klinik 4, Universitätsklinikum Erlangen, Ulmenweg 18, 91054, Erlangen, Deutschland.

Abteilung für Nephrologie und Diabetologie, Evangelisches Klinikum Bethel, Schildescher Str. 99, 33611, Bielefeld, Deutschland.

出版信息

Med Klin Intensivmed Notfmed. 2025 Jun 23. doi: 10.1007/s00063-025-01293-6.

Abstract

Besides mechanical ventilation, renal replacement therapy is the most frequently performed organ replacement therapy in intensive care medicine. However, there is a lack of consensus- and evidence-based recommendations for the implementation of renal replacement therapy according to the best current knowledge and evidence. This guideline describes the topics of starting a renal replacement therapy, modality (diffusion or convection, continuous or intermittent procedures), anticoagulation, adequate dose, and criteria for stopping renal replacement therapy. In addition, the current evidence on adequate anti-infective therapy is presented under the special features of acute kidney injury and renal replacement therapy.

摘要

除机械通气外,肾脏替代治疗是重症医学中最常实施的器官替代治疗。然而,根据当前最佳知识和证据,在肾脏替代治疗的实施方面缺乏基于共识和证据的建议。本指南描述了启动肾脏替代治疗的主题、模式(弥散或对流、持续或间歇性程序)、抗凝、适当剂量以及停止肾脏替代治疗的标准。此外,还根据急性肾损伤和肾脏替代治疗的特点介绍了关于充分抗感染治疗的当前证据。

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