The intensive care unit (ICU) is a common source of high-acuity nephrology consultations. Although advanced chronic kidney disease is associated with increased ICU mortality, the prognosis of acute kidney injury (AKI) requiring renal replacement therapy is far worse, with short-term mortality rates that often exceed 50%. As such, it is essential that practicing nephrologists be comfortable caring for critically ill patients. This Core Curriculum article emphasizes the developments of the last decade since the last Core Curriculum installment on this topic in 2009. We focus on some of the most common causes of AKI in the critical care setting and use these AKI causes to delve into specific topics most relevant to critical care nephrology, including acute respiratory distress syndrome, extracorporeal membrane oxygenation, evolving concepts in fluid management, and shock. We conclude by reviewing the basics of palliative care nephrology and dialysis decision making in the ICU.
Keywords: Acute kidney injury (AKI); abdominal compartment syndrome; acute liver failure; acute respiratory distress syndrome (ARDS); cardiac surgery–associated AKI; continuous renal replacement therapy (CRRT); critical care nephrology; extracorporeal membrane oxygenation (ECMO); fluid overload; intensive care unit (ICU); intraabdominal hypertension; intravenous fluids; palliative care; respiratory failure; review; sepsis; shock.
Copyright © 2020. Published by Elsevier Inc.