Long-term outcome after intensive care: can we protect the kidney?

Long-term outcome--mortality, morbidity and quality of life--is finally receiving attention in the field of intensive care research. A number of recent studies have focused on patient survival and kidney survival after acute renal failure. The present review focuses on the third publication from the Beginning and Ending Supportive Therapy for the Kidney Investigators Writing Committee. Their study took place in 54 intensive care units in 23 countries. The main findings of the Beginning and Ending Supportive Therapy study was that the choice of continuous renal replacement therapy as the initial therapy is not a predictor of hospital survival or of dialysis-free hospital survival, but that it is an independent predictor of renal recovery among survivors. In conclusion, the critical care research community needs to focus on long-term outcome. A number of recent studies of acute renal failure have done just that.