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Djoko Santoso, dr., Sp.PD-KGH, Ph.D.

Fakultas Kedokteran / Departemen Ilmu Penyakit Dalam

Tim Peneliti :

  1. Djoko Santoso --> Peneliti Utama

Tahun : 2009

Halaman Naskah : 7 halaman

Sumber Dana : Mandiri

Besaran Dana : 0

SK. Penetapan : Mandiri

Publikasi : Seminar : Pendidikan Kedokteran Berkelanjutan I : Medical Emergency Simposis

Kategori Penelitian : Kesehatan

Posting : 20-02-2012

Visitor : 4224

Download Article : PDF 3168 byte.

Title :

Management of Acute Renal Failure due to Urosepsis

Author : Djoko Santoso, dr., Sp.PD-KGH, Ph.D.

Year : 2009

Abstact :

Sepsis is a common and often devastating condition characterized by uncontrolled infection and multisystem organ failure. Sepsis is a leading cause of acute renal failure (ARF), but the mechanisms behind ARF remains unclear (Cunningham et al, 2002). ARF occurs in approximately 19 percent of patients with moderate sepsis, 23 percent with severe sepsis, and 51 percent with septic shock when blood cultures are positive  (Rangel-Frausto, 1995; Riedermann et al, 2003; Schrier et al, 2004)
Urosepsis is severe bacterial infection that arise from urinary tract (Stamm, 206). Acute renal failure due to urosepsis can be a fatal illness if the dissemination of the infection can not     be controlled, even if adequate hemodialysis treatment is performed
The common cause of urosepsis is acute pyelonephritis. The other potential source of infection is indwelling urethral catheter, especially in patients catheterized for more than 2 weeks, despite of any precaution measure. Factors associated with an increased risk of catheter-associated UTI include female sex, prolonged catheterization, severe underlying illness, disconnection of the catheter and drainage tube, other types of faulty catheter care, and lack of systemic antimicrobial therapy (Stamm,2006).
Acute renal failure (ARF) is defined conceptually as a rapid (over hours to weeks) and usually reversible decline in GFR that may occur either in the setting of preexisting normal renal function ("classic" ARF) or with pre-existing renal disease ("acute on chronic" renal failure). However, a uniform and precise operational definition of ARF still is not available. The traditionally used term ARF often is used in reference to the subset of patients, often admitted in the intensive care unit, with an acute need for dialysis support. As even modest increases in serum creatinine are associated with a dramatic impact on the risk for mortality, the clinical spectrum of acute decline in GFR is broader, and the minor deteriorations in GFR and kidney injury should be captured in a working clinical definition of kidney damage that allows early detection and intervention. For that reason, the term ARF was replaced recently by that of acute kidney injury (AKI), and the ARF preferably should be restricted to patients who have AKI and need renal replacement therapy (RRT) (Van Biesen et al, 2006; Cruz et al, 2007).

Keyword : sepsis, urosepsis,

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