TY - JOUR
T1 - Early continuous renal replacement therapy for postoperative patient with acute kidney injury following total pancreato-splenectomy
T2 - a case report
AU - Ratnaningrum, Apriliana
AU - Taufik, M. Azhari
AU - Irawany, Vera
AU - Sedono, Rudyanto
N1 - Funding Information:
This article was presented at the 7th International Conference and Exhibition on Indonesian Medical Education and Research Institute (7th ICE on IMERI), Faculty of Medicine, Universitas Indonesia. We appreciate the exceptional support of the 7th ICE on IMERI committee during the manuscript preparation and peer-review process.
Publisher Copyright:
© 2023, The Author(s).
PY - 2023/12
Y1 - 2023/12
N2 - Background: Acute kidney injury is a devastating postoperative complication. Renal replacement therapy is a treatment modality for acute kidney injury. Continuous renal replacement therapy is the treatment of choice for patients with hemodynamic instability. The main question in the management of acute kidney injury is when to initiate the renal replacement therapy. Several studies have demonstrated improvement in patients with septic acute kidney injury, following early continuous renal replacement therapy. To date, no guidelines have been established on the perfect timing to initiate continuous renal replacement therapy. In this case report, we did an early continuous renal replacement therapy as an extracorporeal therapy for blood purification and renal support. Case presentation: Our patient was a 46-year-old male of Malay ethnicity, undergoing total pancreatectomy due to a duodenal tumor. The preoperative assessment showed that the patient was high risk. Intraoperatively, massive surgical bleeding was sustained due to extensive tumor resection; thus, massive blood product transfusion was necessary. After the surgery, the patient suffered from postoperative acute kidney injury. We performed early continuous renal replacement therapy, within 24 hours after the diagnosis of acute kidney injury. Upon completion of continuous renal replacement therapy, the patient’s condition improved, and he was discharged from the intensive care unit on the sixth postoperative day. Conclusion: The timing for the initiation of renal replacement therapy remains controversial. It is clear that the “conventional criteria” for initiating renal replacement therapy need correction. We found that early continuous renal replacement therapy initiated in less than 24 hour after the postoperative acute kidney injury diagnosis gave our patient survival benefit.
AB - Background: Acute kidney injury is a devastating postoperative complication. Renal replacement therapy is a treatment modality for acute kidney injury. Continuous renal replacement therapy is the treatment of choice for patients with hemodynamic instability. The main question in the management of acute kidney injury is when to initiate the renal replacement therapy. Several studies have demonstrated improvement in patients with septic acute kidney injury, following early continuous renal replacement therapy. To date, no guidelines have been established on the perfect timing to initiate continuous renal replacement therapy. In this case report, we did an early continuous renal replacement therapy as an extracorporeal therapy for blood purification and renal support. Case presentation: Our patient was a 46-year-old male of Malay ethnicity, undergoing total pancreatectomy due to a duodenal tumor. The preoperative assessment showed that the patient was high risk. Intraoperatively, massive surgical bleeding was sustained due to extensive tumor resection; thus, massive blood product transfusion was necessary. After the surgery, the patient suffered from postoperative acute kidney injury. We performed early continuous renal replacement therapy, within 24 hours after the diagnosis of acute kidney injury. Upon completion of continuous renal replacement therapy, the patient’s condition improved, and he was discharged from the intensive care unit on the sixth postoperative day. Conclusion: The timing for the initiation of renal replacement therapy remains controversial. It is clear that the “conventional criteria” for initiating renal replacement therapy need correction. We found that early continuous renal replacement therapy initiated in less than 24 hour after the postoperative acute kidney injury diagnosis gave our patient survival benefit.
KW - Acute kidney injury
KW - Case report
KW - Early continuous renal replacement therapy
KW - Pancreato-splenectomy
KW - Postoperative
UR - http://www.scopus.com/inward/record.url?scp=85159427567&partnerID=8YFLogxK
U2 - 10.1186/s13256-023-03923-z
DO - 10.1186/s13256-023-03923-z
M3 - Article
C2 - 37194096
AN - SCOPUS:85159427567
SN - 1752-1947
VL - 17
JO - Journal of Medical Case Reports
JF - Journal of Medical Case Reports
IS - 1
M1 - 201
ER -