Initiation renal replacement therapy. Medical search. Frequent questions

It is one of the clinical hallmarks of renal failure and has been used as a criterion for diagnosing and staging acute kidney injury (AKI), previously referred to as acute renal failure . (medscape.com)
Globally, prerenal insufficiency accounts for approximately 70% of community-acquired cases of acute renal failure and as many as 60% of hospital-acquired cases. (medscape.com)
Spectrum of acute renal failure in the intensive care unit: the PICARD experience. (bmj.com)
14. Liaño F, Pascual J. Epidemiology of acute renal failure: a prospective, multicenter, community-based study. (bmj.com)
Madrid Acute Renal Failure Study Group. (bmj.com)
Epidemiology and outcomes of acute renal failure in hospitalized patients: a national survey. (bmj.com)
17. Lameire N, Van Biesen W, Vanholder R. Acute renal failure. (bmj.com)
Hemodynamically mediated acute renal failure. (bmj.com)
Apoptotic pathways in ischemic acute renal failure. (bmj.com)
Other ongoing clinical trials include investigations into the role of growth factors such as insulinlike growth factor, nitric oxide inhibitors, antioxidants, and antagonists of endothelin receptors in human acute renal failure. (medscape.com)
Patients with acute renal failure (a.k.a. acute kidney injury or AKI) in the ICU experience worse outcomes than patients who do not. (pulmccm.org)
This was a gutsy trial design for both investigators and enrollees: besides their severe acute renal failure, all patients were also either receiving vasopressors, mechanical ventilation or both. (pulmccm.org)

According to a few small trials, treating metabolic acidosis in advanced chronic kidney disease (CKD) with sodium bicarbonate improves nutritional markers and slows progression to end-stage renal disease (ESRD). (medpagetoday.com)
Does treating mild acidosis result in delay in initiation of renal replacement therapy (RRT) for ESRD or result in an improved quality of life (QOL)? (medpagetoday.com)
optimal management of end-stage renal disease (ESRD) in hemodialysis (HD) patients should be more studied because it is a serious risk factor for mortality, being considered an unquestionable global priority. (biomedcentral.com)
Diabetic kidney disease (DKD) is a progressive condition and is an important cause of end stage renal disease (ESRD) as well as a risk factor for cardiovascular morbidity and mortality. (scientificarchives.com)
Glomerulonephritis was found to be the leading cause of end stage renal disease (ESRD) and diabetic nephropathy was the second common cause. (scientificarchives.com)
Adequate pre-dialysis care reduces mortality among end-stage renal disease (ESRD) patients. (cdc.gov)
ESRD compared to those without SCD as the primary cause of renal failure was 2·80 (95% confidence interval [CI] 2·31-3·38). (cdc.gov)
Chronic kidney disease (CKD) occurs among approximately 30% of these individuals and a proportion of them will develop end-stage renal disease (ESRD) (Powars et al , 1991). (cdc.gov)
Renal replacement therapy (RRT) with dialysis (haemo or peritoneal) or kidney transplantation substantially extends the life expectancy of individuals with ESRD. (cdc.gov)

Scholars@Duke publication: Who may not benefit from continuous renal replacement therapy in acute kidney injury? (duke.edu)
This study aimed to identify factors that may predict early kidney recovery (less than 48 hours) or early death (within 48 hours) after initiating continuous renal replacement therapy (CRRT) in acute kidney injury (AKI) patients. (duke.edu)
Background - Sustained low efficiency dialysis (SLED) has emerged as an alternative to continuous renal replacement therapy (CRRT) for the treatment of acute kidney injury (AKI) in critically ill patients. (ices.on.ca)
Continuous renal replacement therapy in cytokine release syndrome following immunotherapy or cellular therapies? (bmj.com)
Based on its pathophysiology and the resemblance of CRS to sepsis and septic shock, as well as based on the principles of initiation of continuous renal replacement therapy (CRRT) in sepsis, we propose the rationale of using CRRT therapy as an adjunct treatment in CRS where all the other approaches have failed in controlling the clinically significant manifestations. (bmj.com)
RRT could be hemodialysis, continuous renal replacement therapy, or any other modality, according to the treatment team. (pulmccm.org)
While these findings effectively prove that there is no survival advantage to early initiation of hemodialysis in critically ill patients with severe acute kidney injury, they don't definitively settle the question of whether early initiation of continuous renal replacement therapy might somehow help, at least in some patients. (pulmccm.org)
Recently, continuous renal replacement therapy (CRRT) has been used to treat acute kidney injury (AKI) to improve survival. (longdom.org)
Implementing a practice change: early initiation of continuous renal replacement therapy during neonatal extracorporeal life support standardizes care and improves short-term outcomes. (musc.edu)
Early Continuous Renal Replacement Therapy Improves Nutrition Delivery in Neonates During Extracorporeal Life Support. (musc.edu)

Suboptimal dialysis initiation (eg, marked by dialysis starts during a hospitalization or without a permanent dialysis access) is not uncommon, 4-6 and individuals with such dialysis starts have reduced access to home dialysis and transplantation, poor clinical outcomes, and increased mortality. (ajmc.com)
Correction: Impact of renal-replacement therapy strategies on outcomes for patients with chronic kidney disease: a secondary analysis of the STARRT-AKI trial. (unityhealth.to)
Early goal-directed therapy (EGDT) has been shown to improve patient outcomes. (longdom.org)
Physiologic renal changes are cornerstone for adequate placental development, and even mildly impaired kidney function is associated with increased probability of adverse pregnancy outcomes. (obgynkey.com)
In this chapter, we address the renal physiological adaptations of pregnancy, the impact of gestation on maternal and fetal outcomes, and the effects of pregnancy on preexisting renal disorders. (obgynkey.com)
The trial's 6-month outcomes suggest that antihypertensive therapy according to a standardized stepped-care, medication-escalation protocol can amplify the BP-lowering effects of renal denervation for at least 6 months after the procedure, Kirtane said when presenting the findings at Transcatheter Cardiovascular Therapeutics (TCT) 2021 . (medscape.com)

Patients were grouped into early kidney recovery group (CRRT discontinuation within 48 hours after initiation, n=52), early death group (death within 48 hours after CRRT initiation, n=52), and the rest as the control group (n=239). (duke.edu)
Compared to SLED recipients, more CRRT recipients were mechanically ventilated (96% vs 86%, p = 0.002) and receiving vasopressors (94% vs 84%, p = 0.01) at the time of RRT initiation. (ices.on.ca)
At 90 days following RRT initiation, 52 (55%) and 126 (67%) SLED and CRRT recipients, respectively, died (adjusted risk ratio (RR) 0.91, 95% CI 0.75-1.11). (ices.on.ca)
Intuition says -- screams, really -- that correcting the derangements with renal replacement therapy (hemodialysis or CRRT) must be helpful. (pulmccm.org)

A comprehensive document with 46 statements are presented, including protection of medical personnel, etiological treatment, diagnosis and treatment of tissue and organ functional impairment, psychological interventions, immunity therapy, nutritional support, and transportation of critically ill COVID-19 patients. (springeropen.com)
In fact, a serum creatinine of 1.0 mg/dL, which is considered normal in nonpregnant subjects, may reflect renal impairment during gestation. (obgynkey.com)
For specific dosing information in patients with renal impairment, refer to the product information of the co-administered protease inhibitor. (who.int)

The aim of this study was to evaluate whether early or late start of renal replacement therapy (RRT) defined by simplified RIFLE (sRIFLE) classification in AKI patients after major abdominal surgery will affect outcome. (biomedcentral.com)

Past studies report higher health care costs among patients with delayed nephrology care and suboptimal dialysis initiation, but they are limited because they focused on patients undergoing dialysis and did not evaluate costs associated with unrecognized disease for patients "upstream," or patients with late-stage CKD. (ajmc.com)
Several studies have also reported higher health care costs (including higher hospital utilization) among patients with late referral to nephrology and unplanned or emergent dialysis initiation. (ajmc.com)
However, it is not known whether serum calcium levels at dialysis initiation have an impact on subsequent prognosis. (fujita-hu.ac.jp)
Conclusions: Serum adjusted calcium levels at dialysis initiation were demonstrated to be associated with all-cause mortality after dialysis initiation. (fujita-hu.ac.jp)
Scores of three clinical domains (effects of kidney disease, burden of kidney disease, and dialysis staff encouragement) and two socioeconomic domains (sexual function and dialysis staff encouragement) were higher in patients on PD compared with those on IHD at one and two years after dialysis initiation. (advancingdialysis.org)

The findings of this study support earlier initiation of acute RRT, and also underscore the importance of predicting prognoses of major abdominal surgical patients with AKI by using RIFLE classification. (biomedcentral.com)
Proteinuria is a major determinant of progression of chronic kidney disease (CKD), which is associated with more rapid worsening of renal function and earlier initiation of renal replacement therapy independent of estimated glomerular filtration rate (eGFR) [ 1 ]. (karger.com)
Earlier initiation of dialysis may have a beneficial impact on survival of critically ill patients with acute kidney injury (AKI). (biomedcentral.com)
A recently published systematic review and meta-analysis on this topic concluded that earlier initiation of RRT in critically ill AKI patients may have a beneficial impact on survival but that, in the absence of new evidence from suitably designed randomized trials, a definitive treatment recommendation cannot be made [ 3 ]. (biomedcentral.com)
The idea that 'earlier' initiation of treatment should be beneficial stems from our belief that sometimes complex interventions may change the course of a disease. (biomedcentral.com)

Exclusion criteria included patients aged less than 18 years, patients with an ICU stay of less than two days, patients who started dialysis before surgery, patients who didn't undergo abdominal surgery, or patients who underwent renal transplantation. (biomedcentral.com)
Chronic kidney disease (CKD) represents a slowly progressive disorder that can eventually require renal replacement therapy (RRT) including dialysis or renal transplantation. (arxiv.org)
Vigorous fluid administration has been successfully used to prevent acute kidney injury following cardiac surgery, cadaveric renal transplantation, hemoglobinuria, myoglobinuria, hyperuricosuria, radiocontrast infusion, and therapy with amphotericin B or cisplatinum. (medscape.com)
Moreover, they may require preceding initiation of renal replacement therapy with dialysis or kidney transplantation. (nutritioninsight.com)

It is often the earliest sign of impaired renal function and poses a diagnostic and management challenge to the clinician. (medscape.com)

Consult a pediatric nephrologist for management of all cases of oliguria, except in children with prerenal insufficiency from dehydration who have promptly responded to fluid therapy or those with mild nephrotoxic injury who have responded to discontinuation of the drug. (medscape.com)
Depending on the specific protease inhibitor with which it is co-administered, ritonavir may be appropriate for use with caution in patients with renal insufficiency. (who.int)

The youngest organ donor was a baby with anencephaly, born in 2014, who lived for only 100 minutes and donated his kidneys to an adult with renal failure. (wikipedia.org)
In the patient group with septic AKI, dialysis should not be seen as a curative intervention, but rather as supportive therapy, preventing the patient from dieing from hyperkalaemia or fluid overload during the period the kidneys are temporarily failing. (biomedcentral.com)

BACKGROUND Acute kidney injury is common in critically ill patients, many of whom receive renal-replacement therapy. (birmingham.ac.uk)
CONCLUSIONS Among critically ill patients with acute kidney injury, an accelerated renal-replacement strategy was not associated with a lower risk of death at 90 days than a standard strategy. (birmingham.ac.uk)
Intensive insulin therapy in critically ill patients. (jamanetwork.com)
There is a lack of guidelines or formal systematic synthesis of evidence for nutrition therapy in older critically ill patients. (annals.edu.sg)
MEDLINE and Embase were searched from inception until 9 February 2022 for studies that enrolled critically ill patients aged ≥60 years and investigated any area of nutrition therapy. (annals.edu.sg)

Atrial natriuretic peptide (ANP) has been shown to improve renal function in animal models of ischemic acute kidney injury, predominantly via afferent arteriolar dilatation. (medscape.com)

Renal failure that results from nephrotoxic injury, interstitial nephritis , or neonatal asphyxia is frequently of the nonoliguric type, is related to a less severe renal injury, and has a better prognosis. (medscape.com)
Intensive insulin therapy and pentastarch resuscitation in severe sepsis. (jamanetwork.com)
Severe immunosuppression can be due to a variety of conditions, including congenital immunodeficiency, human immunodeficiency virus (HIV) infection, leukemia, lymphoma, generalized malignancy or therapy with alkylating agents, antimetabolites, radiation, or large amounts of corticosteroids. (cdc.gov)

In future years, we anticipate more insight into the genetics between childhood-onset SLE and adult-onset SLE to help delineate the best therapies for both subsets of patients. (biomedcentral.com)

2022 United States Renal Data System (USRDS) annual data report: epidemiology of kidney disease in the United States. (bmj.com)

Initiation of renal replacement therapy has a strong impact on HRQOL in comparison with other stages of chronic kidney disease. (advancingdialysis.org)

From the view point of an early renal support strategy, the goal of early RRT is to maintain solute clearance and fluid balance to prevent subsequent multi-organ damage, while waiting for the recovery of renal function [ 8 ]. (biomedcentral.com)
The early phase of renal compensation for reduced perfusion includes autoregulatory maintenance of the GFR via afferent arteriolar dilatation (induced by myogenic responses, tubuloglomerular feedback, and prostaglandins) and via efferent arteriolar constriction (mediated by angiotensin II). (medscape.com)
A retrospective analysis in the previous issue of Critical Care showed that early initiation of renal replacement therapy (RRT), as defined by RIFLE criteria, was not associated with a reduction in hospital mortality. (biomedcentral.com)
The retrospective character of many studies describing the results of early RRT initiation and the validity of RIFLE criteria to determine the need for dialysis can be questioned, in particular when urinary output is not considered. (biomedcentral.com)
Conclusions on the impact of 'early versus late initiation of dialysis' would only be justified when, at the moment patients fulfilled the criteria for dialysis, one group started RRT immediately while for the other group dialysis was delayed for one or more days. (biomedcentral.com)
Some studies have suggested that rapid initiation of RRT in critical illness might help , but others suggested no benefit or even harm from early RRT. (pulmccm.org)
patients getting early RRT had near-identical 60-day mortality (48.5% vs 49.7%) and slower return of native renal function (as measured by spontaneous diuresis). (pulmccm.org)

American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference: definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. (jamanetwork.com)

Clinical question: Does coronary artery bypass grafting added to medical therapy decrease mortality in patients with coronary artery disease and. (the-hospitalist.org)

The glomerular hyperfiltration and the modifications in tubular reabsorption are also responsible for changes in serum levels of analytes that may challenge the interpretation of renal and metabolic conditions ( Table 35.1 ). (obgynkey.com)
E6 and Metabolic syndrome and risks of colon and rectal renal cell carcinoma. (who.int)

Appropriate medical care, defined by Author Manuscript widely disseminated clinical practice guidelines, includes nephrology referral at least 6 months before the anticipated start of RRT and the placement of a functioning arteriovenous fistula (AVF) prior to the initiation of haemodialysis (National Kidney Foundation, 2001a, 2002). (cdc.gov)

Nephrotoxic agents should be avoided because they may worsen the renal injury and delay recovery of function. (medscape.com)
Prescribing medication requires knowledge of the route of elimination and adjustments in dose or frequency based on residual renal function. (medscape.com)
7 days) sustained recovery, relapse with (relapse no recovery) or without altered renal function at hospital discharge (relapse recovery) and sustained renal failure [ 18 ]. (springeropen.com)
Patients with altered renal function at hospital discharge (never reversed or relapse no recovery) had the worst outcome. (springeropen.com)
Measuring serum creatinine and 24-hour urine collection for creatinine clearance are currently the most reliable surrogates of GFR and are the preferred methods to assess renal function during gestation in women with nephropathy. (obgynkey.com)
Renal function should be assessed routinely for potential dose evaluation. (medscape.com)

The findings are welcome "because they add to the totality of the evidence for renal denervation, suggesting - at least in this instance - intermediate-term durability with renal denervation and also the opportunity to reduce medication burden," David E. Kandzari, MD, chief of the Piedmont Heart Institute in Atlanta, Georgia, said at a media briefing held prior to Kirtane's TCT 2021 presentation. (medscape.com)

Patients with oliguric acute kidney injury may present with hypovolemia, euvolemia, or volume overload, and an estimation of fluid status is a prerequisite for initial and ongoing therapy. (medscape.com)
This non-invasive device provides vital and valuable information of the patient's fluid status along with other important parameters to the clinician in order to guide therapy. (maltronint.com)

Proteinuric kidney diseases share an aggressive clinical course of developing end-stage renal disease. (karger.com)
As strict clinical rules on the timing of initiation of dialysis were present in these ICUs during the collection of these data, all patients in fact started at the same 'time point' in their disease, that is, when they fulfilled one of the preset criteria. (biomedcentral.com)
have compared 3,769 to 13,598 matched patients treated or not treated with renal replacement therapy (RRT) in ICU and observed a higher incidence of end-stage renal disease with RRT (2.63 vs. 0.91/100 patient-years, hazard ratio = 3.23 [2.70-3.86]) [ 20 ]. (springeropen.com)
Introduction Recent advances in genomic technology have allowed better delineation of renal conditions, the identification of new kidney disease genes and subsequent targets for therapy. (bmj.com)
The aim of this study is to explore the clinical utility and cost-effectiveness of genomic testing within a national cohort of patients with suspected genetic kidney disease who attend multidisciplinary renal genetics clinics. (bmj.com)
Patients will be included if they are referred to one of the multidisciplinary renal genetics clinics and are deemed likely to have a genetic basis to their kidney disease by the multidisciplinary renal genetics team. (bmj.com)
Furthermore, pregnancy can worsen the course of preexisting nephropathy or unmask an undiagnosed primary renal disease. (obgynkey.com)
9 , 10 In general, the assessment of GFR with current methods, such as the modification of diet in renal disease (MDRD), underestimates disease and should not be considered a reliable tool for clinical management. (obgynkey.com)
In Bangladesh, the causes of CKD G5 among 954 patients who were on HD in 2012-2013 were chronic glomerulonephritis (25.5%), diabetic nephropathy (41%) and hypertensive renal disease (33%) [ 20 ]. (scientificarchives.com)

In clinical situations in which renal hypoperfusion or toxic injury is anticipated, therapy with fluids, mannitol, diuretics, and renal-dose dopamine is used to prevent or reverse renal injury. (medscape.com)
The benefit of renal-dose dopamine therapy is controversial. (medscape.com)
The finding comes from extended follow-up of a study that had previously seen renal denervation therapy produce meaningful declines in BP, elevated despite initial fixed-dose triple-drug therapy, over 2 months. (medscape.com)

Hydrocortisone therapy for patients with septic shock. (jamanetwork.com)

3 While those using peritoneal dialysis (PD) reported their HRQOL as much higher than patients receiving conventional in-center hemodialysis (IHD), 4 frequent hospitalizations and administering daily treatments can increase the burden of therapy, impacting patients and care partners alike. (advancingdialysis.org)

Proteinuria is usually a sign of renal injury and if persistent may represent ongoing renal damage. (obgynkey.com)

The 136 patients with an ambulatory BP of 135/85 mmHg or more after a month of treatment with the triple pill, signifying drug-resistant hypertension, underwent angiography and were assigned to renal denervation therapy (69 patients) or to a sham control procedure (67 patients). (medscape.com)

Current statistics report an increase in the incidence of hematological and oncological malignancies, 1 but treatment with immune-based therapies have also risen in both use and efficacy. (bmj.com)
However, in current practice, the efficacy of therapies such as dopamine, fenoldopam, and natriuretic peptides for the treatment of established acute kidney injury remains unproven and their routine use is not recommended. (medscape.com)
It's notable that the sham group had further and dramatic reductions in blood pressure with the initiation of aldosterone antagonists," evidence that "lifestyle modification and pharmacotherapy, especially as shown in this trial, are effective and standard of care for the treatment of hypertension," Kirtane noted. (medscape.com)
After 2 months of follow-up, during which patients and clinicians were blinded to treatment group, ambulatory systolic BP had fallen a mean of 8 mmHg in those who had undergone renal denervation with triple-drug therapy. (medscape.com)
Ejection fraction should be assessed prior to initiation of treatment and as clinically indicated. (medscape.com)
Eight patients were treated by extraction, orthodontic treatment, and space closure or prosthetic replacement, with a mean treatment time of 2.83 ± 2.66 years. (bvsalud.org)
HA565 trade name] is indicated as a pharmacokinetic enhancer for protease inhibitors when these are used in combination therapy with other antiretroviral agents for the treatment of HIV-1 infected patients. (who.int)

In most clinical situations, acute oliguria is reversible and does not result in intrinsic renal failure. (medscape.com)
Clinical question: Can the use of procalcitonin levels to determine when to discontinue antibiotic therapy safely reduce the duration of. (the-hospitalist.org)
Clinical question: Does the use of high-flow oxygen therapy for 24 hours following extubation reduce the risk of reintubation in low-risk patients. (the-hospitalist.org)
Please consult the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines™) for Antiemesis for appropriate antiemetic therapy. (medscape.com)

During the past decade, experimental studies in animals and humans have focused on restoration of renal hemodynamics and tubule cell integrity. (medscape.com)

Bittencourt PL, Farias AQ, Terra C. Renal failure in cirrhosis: Emerging concepts. (wjgnet.com)
But it's never been shown to what extent renal failure itself makes critical illness worse, or whether treating it (or when) helps. (pulmccm.org)

To better manage CRS there is a need for specific therapies or to repurpose strategies that are already known to be useful in similar situations. (bmj.com)
Current management strategies for CRS are represented by anticytokine directed therapies and corticosteroids. (bmj.com)

New evidence suggests that it can augment the blood pressure (BP) reductions achieved with aggressively stepped-up antihypertensive therapy in patients who hadn't responded well to first-line agents. (medscape.com)
In the next stage of the trial, called RADIANCE-HTN TRIO , patients in both the renal denervation and control groups at 6 months showed further BP reductions after stepwise intensification of antihypertensive therapy, starting with an aldosterone antagonist. (medscape.com)

Potential adverse effects include difficulty taking large pills (pill burden), high blood pressure, and volume overload from sodium content of sodium bicarbonate therapy. (medpagetoday.com)
Participants who have adverse event (AEs) due to previous anticancer therapies must have recovered to =Grade 1 or baseline. (who.int)

Blood glucose measurements were not available at 8 AM for 3 patients receiving intensive insulin and for 2 receiving conventional glucose therapy. (jamanetwork.com)

Specific medical therapies may be applied to many liver diseases in an effort to diminish symptoms and to prevent or forestall the development of cirrhosis. (medscape.com)

A trial of intravenous (IV) mannitol or furosemide should be attempted in a patient with oliguria for less than 48 hours who has not responded to adequate hydration (although meta-analysis studies have failed to document a clear benefit that can be associated with the use of either furosemide or mannitol therapy). (medscape.com)
The opportunity to reduce medication burden," he said, "is one of the key drivers of patient motivation for an alternative therapy approach like renal denervation. (medscape.com)

BioScan touch i8 is a non-invasive monitor used in hospital departments such as ICU, Renal, Cardiology, Cancer and many more to assess and monitor Covid-19 patients and others in order to help physicians understand the impact of the virus. (maltronint.com)

We feel that renal denervation can offer an additional but not a replacement option to further lower blood pressure, especially for patients whose blood pressure is uncontrolled despite genuine attempts to institute conventional therapies. (medscape.com)

Unfortunately, there is currently no commonly used predictive tool for RRT initiation. (arxiv.org)

Oliguria may result from prerenal, intrinsic renal, or postrenal processes. (medscape.com)

Patients may require IV hydration and electrolyte replacement. (medscape.com)

Anatomy1

Diseases27

Chemicals and Drugs19

Analytical, Diagnostic and Therapeutic Techniques and Equipment55

Phenomena and Processes9

Disciplines and Occupations1

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Health Care38

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Acute renal f12

ESRD9

Continuous10

Outcomes6

CRRT4

Impairment3

Start of renal replace1

Dialysis initiation5

Earlier initiation5

Transplantation4

Impaired renal function1

Insufficiency2

Kidneys2

Critically ill patients5

Ischemic acute1

Severe3

Onset1

20221

Chronic kidney1

Early7

Sepsis1

Mortality in patients1

Metabolic2

Nephrology1

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20211

Fluid2

Disease9

Dose3

Septic shock1

Hemodialysis1

Proteinuria1

Underwent1

Treatment7

Clinical4

Humans1

Failure2

Strategies2

Antihypertensive therapy2

Adverse2

Intensive1

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Oliguria1

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