title: Prevention of acute kidney injury in Intensive Care Units.
abstract: Acute kidney injury (AKI) is a growing concern in Intensive Care Units. The advanced age of our patients, with the increase in associated morbidity and the complexity of the treatments provided favor the development of AKI. Since no effective treatment for AKI is available, all efforts are aimed at prevention and early detection of the disorder in order to establish secondary preventive measures to impede AKI progression. In critical patients, the most frequent causes are sepsis and situations that result in renal hypoperfusion; preventive measures are therefore directed at securing hydration and correct hemodynamics through fluid perfusion and the use of inotropic or vasoactive drugs, according to the underlying disease condition. Apart from these circumstances, a number of situations could lead to AKI, related to the administration of nephrotoxic drugs, intra-tubular deposits, the administration of iodinated contrast media, liver failure and major surgery (mainly heart surgery). In these cases, in addition to hydration, there are other specific preventive measures adapted to each condition.
authors.affiliation: Intensive Care Medicine, Hospital General Universitario de Castellón, Spain. Electronic address: masf.sonia@gmail.com.
authors.forename: S
authors.initials: S
authors.lastname: Mas-Font
authors.affiliation: Intensive Care Medicine, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Ros-Martinez
authors.affiliation: Intensive Care Medicine, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Pérez-Calvo
authors.affiliation: Intensive Care Medicine, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Villa-Díaz
authors.affiliation: Intensive Care Medicine, Complejo Hospitalario de Navarra, Pamplona, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Aldunate-Calvo
authors.affiliation: Intensive Care Medicine, Hospital General Universitario de Castellón, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Moreno-Clari
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control* / Q000628:therapy; D003287:Contrast Media / Q000009:adverse effects; D003422:Critical Care / Q000379:methods*; D004232:Diuretics / Q000627:therapeutic use; D018818:Fenoldopam / Q000627:therapeutic use; D005440:Fluid Therapy; D006439:Hemodynamics; D006801:Humans; D007362:Intensive Care Units; D017093:Liver Failure / Q000150:complications / Q000628:therapy; D011183:Postoperative Complications / Q000517:prevention & control; D012079:Renal Circulation / Q000187:drug effects; D012206:Rhabdomyolysis / Q000150:complications / Q000628:therapy; D012307:Risk Factors; D055502:Secondary Prevention; D018805:Sepsis / Q000150:complications / Q000628:therapy; D014662:Vasoconstrictor Agents / Q000009:adverse effects
chemical_list: D003287:Contrast Media; D004232:Diuretics; D014662:Vasoconstrictor Agents; D018818:Fenoldopam
keywords: Acute kidney injury; Lesión renal aguda; Prevención primaria; Prevención secundaria; Primary prevention; Secondary prevention