Acute Renal Failure and Its Complications, Indications for Emergent Dialysis, and Dialysis Modalities

Acute kidney injury or acute renal failure is commonly observed in the critically ill patient with hemodynamic compromise. Dialysis is frequently used in the intensive care units as part of the critical care management of metabolic derangements fluid status and electrolyte issues. It is imperative that the bedside critical care nurse is able to identify acute kidney injury and is familiar with the modalities used to manage the metabolic consequences of renal failure, particularly important as the bedside nurse is operating the continuous renal replacement machine at the bedside. This article will review the common risks and causes of acute kidney injury in the critically ill patient, indications for conservative management versus initiation of renal replacement therapy, prevention of acute kidney injury, and important consequences of renal failure such as electrolyte disturbances and uremia. We will also briefly touch on specific conditions where acute kidney injury is common such as hepatorenal syndrome, cardiorenal syndrome, rhabdomyolysis, and tumor lysis syndrome.