Nephrologie in der Zentralen Notaufnahme

In an emergency department of a maximum care hospital such as ours, approximately 45,000–50,000 attend each year. In the Darmstadt Hospital the group of internal disease symptoms in 2023 was approximately 12,000 patients of which 8–10% were patients in nephrology. Even if the total number does not seem to be large, the severity of the diseases and the multimorbidity of the patients are high. Neurological diagnoses, either by the emergency services or outpatient practices, necessitating hospital admittance are not uncommon, which ultimately turn out to be an underlying nephrological problem. Furthermore, acute disorders of renal function occur as comorbidities of other leading main diagnoses. The group of patients requiring dialysis arrive in the central emergency department with diverse dialysis-associated (pulmonary edema, hyperkalemia, problems with dialysis access, atrial catheter infections) and nondialysis-associated (stroke, myocardial ischemia, cardiac arrhythmias, mesenteric ischemia etc.) problems. The recognition and treatment of nephrological problems in the emergency department necessitate standardized diagnostics, interdisciplinary cooperation and rapid communication with the specialized nephrological department.