title: Con: Dialy- and continuous renal replacement (CRRT) trauma during renal replacement therapy: still under-recognized but on the way to better diagnostic understanding and prevention.
abstract: Dialy- and continuous renal replacement (CRRT) trauma are still un(der)recognized conditions that may be encountered during blood purification therapy. This particular form of trauma requires timely identification, a better understanding of pathophysiology and a definition of at-risk groups to prevent or correct any associated unwarranted effects. Among others, progress in the knowledge of antimicrobial pharmacokinetic/pharmacodynamic (PK/PD) behaviour during CRRT to obtain more efficient antimicrobial therapy with less side-effects is one key example of limiting CRRT trauma. Optimal anticipation and prevention of CRRT trauma will preserve the safe use of CRRT in haemodynamically unstable critically ill patients with acute kidney injury (AKI), especially in septic patients who are at the greatest risk.
authors.affiliation: Internist-Nephrologist-Intensivist Universitair Ziekenhuis Brussel, Vrije Universitieit Brussel, Brussels, Belgium.
authors.forename: Patrick M
authors.initials: PM
authors.lastname: Honoré
authors.forename: Rita
authors.initials: R
authors.lastname: Jacobs
authors.forename: Olivier
authors.initials: O
authors.lastname: Joannes-Boyau
authors.forename: Elisabeth
authors.initials: E
authors.lastname: De Waele
authors.forename: Viola
authors.initials: V
authors.lastname: Van Gorp
authors.forename: Willem
authors.initials: W
authors.lastname: Boer
authors.forename: Herbert D
authors.initials: HD
authors.lastname: Spapen
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control*; D000890:Anti-Infective Agents / Q000008:administration & dosage; D001424:Bacterial Infections / Q000517:prevention & control; D016638:Critical Illness; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D006435:Renal Dialysis / Q000009:adverse effects*; D017582:Renal Replacement Therapy / Q000009:adverse effects*
chemical_list: D000890:Anti-Infective Agents
keywords: AKI; CRRT-trauma; antibiotic dosing; dialy-trauma