Purpose of review: Data from the mid 1970s relating to the clinical features, pathogenesis, treatment and outcome of patients affected by acute renal failure were compared with data reported in the literature in 2005.
Recent findings: The differences in patient characteristics over the last 30 years are profound and claims that the outcome of acute renal failure has not changed over time are equally misleading. Thirty years later patients are older, have more comorbidities, develop renal failure in association with interventions (liver transplantation, lung transplantation, heart and lung transplantation) that essentially did not exist in the 1970s, are sicker with more complex symptoms, receive more effective therapies and survive at higher rates once outcome is adjusted for illness severity.
Summary: The treatment of critically ill patients with acute renal failure has changed dramatically over the last 30 years. As treatment has increased in efficacy and sophistication, so has the severity of the condition.