TY - CHAP M1 - Book, Section TI - Renal Failure A1 - Beyene, Robel T. A1 - Miller, Richard S. A1 - Eastham, Shannon C. A2 - Feliciano, David V. A2 - Mattox, Kenneth L. A2 - Moore, Ernest E. PY - 2020 T2 - Trauma, 9e AB - KEY POINTSEighty-five percent of renal blood flow perfuses the outer cortical glomeruli, whereas the remaining 15% perfuses the juxtamedullary glomeruli.The final concentration and volume of urine vary with plasma volume, serum osmolality, release of antidiuretic hormone (ADH), and other factors.Renal failure is classified by the RIFLE (Risk, Injury, Failure, Loss, and End Stage), AKIN (Acute Kidney Injury Network), or KDIGO (Kidney Disease: Improving Global Outcomes) systems.The incidence of renal failure after trauma is 3% to 9%.Causes of renal failure after trauma include hemorrhage, hypovolemia, functional prerenal renal failure, toxins (eg, antibiotics), contrast nephropathy, sepsis, and rhabdomyolysis.Current KDIGO guidelines promote the use of isotonic crystalloid solutions over colloids for the initial volume resuscitation in patients at risk for or with acute kidney injury.Overall energy use is not affected by renal failure alone, and calorie repletion should not be increased based solely on this finding.Much as with patients with chronic kidney disease, indications for acute renal replacement therapy include hyperkalemia resistant to usual therapy, acidosis, uremia, and severe volume overload. SN - PB - McGraw Hill CY - New York, NY Y2 - 2024/04/19 UR - accesssurgery.mhmedical.com/content.aspx?aid=1175136995 ER -