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Báo cáo khoa học: "Recent evolution of renal replacement therapy in the critically ill patient"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Recent evolution of renal replacement therapy in the critically ill patient. | Available online http ccforum.eom content 10 1 123 Commentary Recent evolution of renal replacement therapy in the critically ill patient Claudio Ronco Department of Nephrology St Bortolo Hospital Vicenza Italy Corresponding author Claudio Ronco cronco@goldnet.it Published 17 February 2006 This article is online at http ccforum.com content 10 1 123 2006 BioMed Central Ltd Critical Care 2006 10 123 doi 10.1186 cc4843 Abstract The epidemiology of severe acute renal failure has dramatically changed in the past decade. Its leading cause is sepsis and the syndrome develops mostly in the intensive care unit as part of multiple organ dysfunction syndrome. After the significant improvements obtained from the mid 1970s to the mid 1990s the past decade has seen a dramatic evolution in technology leading to new machines and new techniques for renal and multiple organ support. Extracorporeal therapies are now performed using adequate treatment doses which have resulted in improved survival in the general population. At the same time patients with sepsis seem to benefit from the use of increased doses as in the case of high-volume hemofiltration or of increased membrane permeability and sorbents as in the case of continuous plasmafiltration adsorption. The humoral theory of sepsis and the peak concentration hypothesis have spurred a significant interest in the use of such extracorporeal therapies for renal support and possibly for the therapy of sepsis. Ongoing research and prospective studies will further elucidate the role of such therapies in this setting. In the past decade the change in the epidemiology of acute renal failure has made critical care nephrology an emerging sub-speciality of intensive care medicine. Dedicated literature and a series of physicians and nurses have made an effort to bridge the knowledge and experience from nephrology and critical care medicine in response to an increased incidence of acute kidney injury in intensive care unit ICU patients 1 . .