Microbial control in renal support for acute kidney injury

Renal support offers a lifeline for our patients with acute kidney injury but the decision to start it requires a careful evaluation of both its benefits and its risks. Among the latter must be included the threat from microorganisms. The hazards associated with vascular access are real, accepted but also reducible. We discuss the nature of the problem and measures that might reduce the risk. We also discuss a different potential hazard--that of bacterial contamination of the fluids used in our renal therapies. Although a well-established fact of chronic hemodialysis practice, its scale and relevance in acute renal support has only just started to be defined.