Concomitant Lung and Kidney Disorders in Critically Ill Patients: Core Curriculum 2022

Am J Kidney Dis. 2022 Apr;79(4):601-612. doi: 10.1053/j.ajkd.2021.06.023. Epub 2021 Nov 17.

Abstract

The lungs and kidneys are cooperative and interdependent organs that secure the homeostasis of the body. Volume and acid-base disorders sit at the nexus between these two systems. However, lung-kidney interactions affect the management of many other conditions, especially among critically ill patients. Therefore, management of one system cannot proceed without a thorough understanding of the physiology of the other. This installment of AJKD's Core Curriculum in Nephrology discusses the complex decision-making required in treating concomitant respiratory and kidney disorders. We cover systemic diseases of the pulmonary and glomerular capillaries, acute decompensated heart failure, management of acid-base disorders in acute respiratory distress syndrome and chronic obstructive pulmonary disease, and venous thromboembolism. Through a case-based approach, we weigh the factors affecting the risks and benefits of therapies to enable the reader to individualize treatment decisions in these challenging scenarios.

Keywords: Diffuse alveolar hemorrhage (DAH); acute decompensated heart failure (ADHF); acute respiratory distress syndrome (ARDS); chronic kidney disease (CKD); dyspnea; glomerulonephritis; intensive care unit (ICU); kidney function; mechanical ventilation; pulmonary capillaritis; renal failure; review; venous thromboembolism (VTE).

Publication types

  • Review

MeSH terms

  • Critical Illness* / therapy
  • Curriculum
  • Humans
  • Kidney
  • Lung
  • Nephrology* / education