Bellomo R, Ronco C
Department of Intensive Care, Austin & Repatriation Medical Centre, Melbourne, Australia.
Kidney Int Suppl. 1998 May;66:S106-9.
The decision to initiate renal replacement therapy is usually based on a careful assessment of conflicting priorities in the care of critically ill patients. It is particularly difficult because of the lack of information on what are the optimal criteria and indications for the application of renal replacement therapy (RRT) in the intensive care unit (ICU). As we will discuss in this paper, even though there are several time-honored indications for initiating dialytic therapy in patients with near end-stage renal failure, such indications may not apply to the management of acute renal failure (ARF). In fact, there are several reasons why a more aggressive approach and an earlier intervention may be justified in the ICU.
启动肾脏替代治疗的决定通常基于对重症患者护理中相互冲突的优先事项的仔细评估。由于缺乏关于在重症监护病房（ICU）中应用肾脏替代治疗（RRT）的最佳标准和指征的信息，这一决定尤其困难。正如我们将在本文中讨论的，尽管在接近终末期肾衰竭患者中启动透析治疗有几个长期存在的指征，但这些指征可能不适用于急性肾衰竭（ARF）的管理。事实上，在ICU中采取更积极的方法和更早进行干预有几个原因。
