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Semin Respir Crit Care Med 2006; 27(3): 262-273
DOI: 10.1055/s-2006-945527
Published by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Acute Renal Failure in the Intensive Care Unit

Steven D. Weisbord1 , 2 , 3 , Paul M. Palevsky1 , 3
  • 1Renal Section, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania
  • 2Center for Health Equity Research and Promotion, Pittsburgh, Pennsylvania
  • 3Renal-Electrolyte Division, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
Further Information

Publication History

Publication Date:
21 June 2006 (online)

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ABSTRACT

Acute renal failure (ARF) is a common complication in critically ill patients, with ARF requiring renal replacement therapy (RRT) developing in ~5 to 10% of intensive care unit (ICU) patients. Epidemiological studies have demonstrated that ARF is an independent risk factor for mortality. Interventions to prevent the development of ARF are currently limited to a small number of settings, primarily radiocontrast nephropathy and rhabdomyolysis. There are no effective pharmacological agents for the treatment of established ARF. Renal replacement therapy remains the primary treatment for patients with severe ARF; however, the data guiding selection of modality of RRT and the optimal timing of initiation and dose of therapy are inconclusive. This review focuses on the epidemiology and diagnostic approach to ARF in the ICU and summarizes our current understanding of therapeutic approaches including RRT.

KEYWORDS

Acute renal failure - renal replacement therapy

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Paul M PalevskyM.D. 

Rm. 7E123 (111F-U), VA Pittsburgh Healthcare System

University Drive Division, Pittsburgh, PA 15240

Email: palevsky@pitt.edu

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