Acute Kidney Injury and Renal Replacement Therapy (RRT) in ICU: The Nephrology or Intensive Care Nurse Role

Abstract

INTRODUCTION: Acute kidney injury (AKI) has become a known complication of individuals admitted to the intensive care unit (ICU). The increase in AKI occurrence in ICU translates to increasing use of Renal Replacement Therapies (RRT), hence the need for more defined roles among the critical care and nephrology trained nurses. The paper aimed to critically analyze the role of intensive care and nephrology trained nurses regarding the management of AKI patients in ICU requiring RRT. METHODS: A review of published literature was done using the appropriate search words. The following databases were used to identify articles for the review: MEDLINE, CINAHL, PubMed, EBSCO Host and the search engine Google-scholar and Google. The criteria included reviewing literature published from 2000 to 2020. An in-depth analysis of documents and studies were done using descriptive qualitative content analysis. RESULTS: Regarding training, entry requirements for both specialties (nephrology and intensive care nursing) include a diploma or a degree in nursing. The post-basic training for the two specialties is offered at varying levels ranging from certificate, diploma, bachelors and master’s programs. In practice, three care models used by nurses when performing renal replacement therapies in ICU were identified by relevant literature. These models were the nephrology nurse- led, ICU nurse-led and the collaborative (nephrology and ICU trained). CONCLUSION: There is a wide variation in the management of AKI patients requiring renal replacement therapy (RRT) in ICU. However, the need for nephrology nurses is evident as they will meet the current and future challenges of delivering high-quality care to patients with AKI in ICU settings.

Keywords

• acute renal injury
• renal dialysis
• renal nursing
• critical care nursing