Overview

Approximately 50% of patients in the intensive care unit (ICU) develop acute kidney injury (AKI) and more than 10% need dialysis. There is no treatment for AKI. Care is aiming for optimization of circulation and blood flow to the kidneys and avoiding nephrotoxic agents.

There is conflicting data concerning whether early or late dialysis is harmful for the kidneys. No one has examined the physiological changes in the kidney when starting dialysis and which blood pressure that leads to most optimal physiological conditions for the kidneys during dialysis. In this descriptive study of 20 ICU patients suffering from AKI we aim to investigate renal physiology when starting continuous renal replacement therapy (CRRT) and also at different target blood pressures using retrograde renal vein thermodilution technique. In parallel we will also investigate and validate this invasive method with contrast enhanced ultrasound of the kidneys.

Eligibility

Inclusion Criteria:

        AKI, according to KDIGO, stage 2 or 3 but with preserved urine production. Treated in the
        ICU at Sahlgrenska University Hospital Written, signed informed consent Male and female
        subjects ≥18 years
        Exclusion Criteria:
        Emergency need for dialysis Allergy to contrast media (used for CEUS)