الفهرس 
Anatomy of the KidneyOnly 14 pages are availabe for public view
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Abstract
S
epsis is defined as an inflammatory response to microorganisms or the invasion of normally sterile host tissue by these organisms. The host inflammatory response in sepsis may lead to multiple organ dysfunction syndrome (MODS) and ultimately death.
Acute kidney injury (AKI) is a frequent and serious complication of sepsis in intensive care unit (ICU) patients as part of multiple organ dysfunction syndromes. It further worsens prognosis and increases cost of care.
Extracorporeal blood purification techniques can be applied to prevent these complications and improve homeostasis. Renal replacement therapy (RRT) is the mainstay of therapy. Adequacy of dialysis is likely to be linked to better outcome. Various modalities of renal replacement therapy include continuous venovenous hemofiltration, intermittent hemodialysis, and peritoneal dialysis, each with its technical variations but with a common fundamental principle of removing unwanted solutes and water through a semipermeable membrane. The membranes used are either biologic (peritoneum) or artificial (hemodialysis or hemofiltration membranes) and have characteristic advantages and disadvantages.
For many years, intermittent hemodialysis (IHD) was the only treatment option for patients with AKI in the ICU. In numerous countries, it is still the most frequently used modality. Continuous venovenous hemofiltration (CVVH) was subsequently proposed as an alternative to IHD in the critically ill, because it was better tolerated by septic patients, the continuous regulation of fluid and nutritional support. and also remove mediators of sepsis from circulation.
Other new approaches were introduced rather than intermittent therapy such as slow extended dialysis, slow low-efficiency daily dialysis, and intermittent extended hemofiltration. These techniques seek to adapt intermittent hemodialysis to the clinical circumstances and increase its tolerance and its clearances. Such hybrid approaches represent a welcome improvement in dialysis support and a clear recognition that acute renal failure patients should not receive the dialysis offered to patients with end-stage renal failure.