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Acute renal failure in the critically ill patient
Vivian E Abernethy1, Wilfred Lieberthal
1Boston University School of Medicine, Renal Section, Evans Biomedical Research Center, 5th Floor, Room 537, 650 Albany Street, Boston, MA 02118, USA.
Critical Care Clinics
|June 11, 2002
Summary
This review covers acute renal failure in critically ill patients, detailing common causes like pre-renal azotemia and acute tubular necrosis from surgery, rhabdomyolysis, or sepsis, alongside rarer intensive care unit-specific causes.
Area of Science:
- Nephrology
- Critical Care Medicine
Background:
- Acute renal failure (ARF) is a significant complication in critically ill patients.
- Common forms include pre-renal azotemia and acute tubular necrosis (ATN).
Purpose of the Study:
- To review the epidemiology, pathogenesis, and prevention of common ARF types in the critically ill.
- To briefly discuss unusual ARF causes specific to the intensive care unit (ICU).
Main Methods:
- Literature review focusing on ARF in critical care settings.
- Synthesis of information on epidemiology, pathogenesis, and prevention strategies.
Main Results:
- Pre-renal azotemia and ATN are the most frequent causes of ARF in critically ill patients.
- ATN is associated with postoperative states, rhabdomyolysis, and sepsis.
- Certain uncommon ARF etiologies are prevalent in the ICU.
Conclusions:
- Understanding the epidemiology and pathogenesis of ARF is crucial for prevention in critically ill patients.
- Effective prevention and management strategies are essential for improving outcomes in ICU patients with ARF.