Nephrologische Notfälle

The management of acute renal diseases in emergency medicine is often challenging and complex. Acute kidney injury (AKI) is frequently found in older patients presenting to the emergency department with unspecific complaints and general discomfort. The management is determined by the specific cause, whereby an underlying acute glomerulonephritis (GN) or thrombotic microangiopathy (TMA) must not be missed. Chronic kidney disease (CKD) is often associated with severe cardiovascular comorbidities, while altered pharmacokinetics and impaired diuresis must be taken into consideration. In the acute treatment of patients requiring chronic dialysis additional characteristics must be considered, especially concerning complications of the dialysis treatment itself and also regarding the vascular dialysis access (arteriovenous, AV, fistula or shunt, tunnelled atrial catheter).