When is dialysis indicated in acute kidney injury?
The indications for dialysis in patients with acute kidney injury (AKI), as well as the dose and timing of initiation, remain uncertain. Recent data have suggested that early initiation of renal replacement therapy (RRT) may be associated with decreased mortality but not with the recovery of kidney function. A blood urea nitrogen (BUN) level of 75 mg/dL is a useful indicator for dialysis in asymptomatic patients, but one that is based on studies with limitations. Different parameters, including absolute and relative indicators, are needed. Currently, nephrologists should consider the trajectory of disease, and the clinical condition and prognosis of the patient are more important than numerical values in the decision to initiate dialysis.
do Nascimento
Ginivaldo Victor Ribeiro
GV
Department of Medicine, Diferencial Integral School, FACID, Teresina, Piauí, Brazil. gvictor.m@uol.com.br
Gabriel
Daniela Ponce
DP
Abrão
Juliana Maria Gera
JM
Balbi
André Luis
AL
D058186:Acute Kidney Injury / Q000503:physiopathology / Q000628:therapy*; D001806:Blood Urea Nitrogen; D006801:Humans; D006435:Renal Dialysis