Patients in the emergency room are often causally or concomitantly also have an acute or chronic kidney disease. Often the kidney disease and its extent at admission are not known. However, a pre-existing chronic kidney disease as well as an acute renal failure significantly determines the clinical course, the meaningful clinical courses of action, the mortality and the hospital stay.
To assess and monitor the progress of a kidney dysfunction, the determination of creatinine and the calculation of the estimated glomerular filtration rate (eGFR) is the gold standard. Many other new biomarkers have been studied in terms of diagnostics and risk assessment, but they can only complement and not replace the nationwide and rapidly available creatinine determination.
Content of the lecture is the importance of creatinine determination as an emergency parameter in the emergency department and as a course parameter in the intensive care unit. In particular, practical action paths for the nephrological patient in the emergency department and in the intensive care unit due to pathologically altered renal function parameters should be shown.
An integral part of many screening protocols for emergency admissions is the assessment of kidney function. By determining, among other things, creatinine levels and the eGFR, patients with acute renal failure (ANV) can be identified quickly.
In addition, renal status can be determined prior to a CT or MRI scan to assess the risk of contrast agent-induced renal failure. In addition, creatinine levels may be a critical factor in avoiding a crowded ER and optimizing a patient's length of stay.
In the webinar Dr. med. Christian Forster explains the importance of the parameter creatinine from the point of view of a nephrologically oriented emergency physician, explains the value of the ad hoc availability of creatinine in emergency medicine and discusses possible benefits for process optimization in the emergency department.
Dr. med. Christian Forster
Senior Physician in the Central Emergency Department
After studying human medicine at the University of Erlangen, Dr. med.med. Christian Forster, the assistant doctor at the Medical Clinic 4 of the University Hospital Erlangen. There he acquired the specialist titles "Internal Medicine" and "Nephrology". For many years he worked as a ward physician on the nephrological intensive care unit of the University Hospital Erlangen. He gained a wealth of experience, in particular in the care of nephrological emergency and intensive care patients. A special focus was the care of patients with multiple organ failure. He has published on nephrological and intensive care topics, including "Critical Care". He has also acquired a special connection to emergency medicine through his work in the emergency medical service.
Currently, Dr. Ing. med. Christian Forster works as a senior physician in the Central Emergency Department at the Klinikum Fürth. As a nephrologist he participates in the nephrological consortium service of the clinic. In the unusual constellation as a nephrologist in the emergency room, he mainly takes care of nephrological emergency and intensive care patients.
Dr. In addition to the specialist title "Internal Medicine" and "Nephrology, Christian Forster owns the recognition and expertise" Emergency Medicine "," Special Internal Intensive Care Medicine ", as well as" Diabetologist DDG "and" Hypertensiologist DHL ".