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INTRODUCTION There is no consensus definition of acute renal failure (ARF) in critically ill patients. More than 30 different definitions have been used in the literature, creating much confusion and making comparisons difficult. Similarly, strong debate exists on the validity and clinical relevance of animal models of ARF; on choices of fluid management(More)
In response to the recently released 2012 KDIGO (Kidney Disease: Improving Global Outcomes) clinical practice guideline for acute kidney injury (AKI), the National Kidney Foundation organized a group of US experts in adult and pediatric AKI and critical care nephrology to review the recommendations and comment on their relevancy in the context of current US(More)
BACKGROUND Management of acute renal failure (ARF) in the critically ill is extremely variable and there are no published standards for the provision of renal replacement therapy in this population. We sought to review the available evidence, make evidence-based practice recommendations, and delineate key questions for future study. METHODS We undertook(More)
The optimal management of renal replacement therapy (RRT) in acute kidney injury (AKI) remains uncertain. Although it is well accepted that initiation of RRT in patients with progressive azotemia prior to the development of overt uremic manifestations is associated with improved survival, whether there is benefit to even earlier initiation of therapy is(More)
Although the use of renal replacement therapy (RRT) to support critically ill patients with acute kidney injury (AKI) has become routine, many of the fundamental questions regarding optimal management of RRT remain. This review summarizes current evidence regarding the timing of initiation of RRT, the selection of the specific modality of RRT, and(More)
BACKGROUND Survivors of critical illness complicated by acute kidney injury requiring renal replacement therapy (RRT) are at an increased risk of dialysis dependence and death but the mechanisms are unknown. METHODS In a multicenter, prospective, cohort study of 817 critically ill patients receiving RRT, we examined association between Day 1 plasma(More)
Determination of the optimal dose of renal replacement therapy in critically ill patients with acute kidney injury has been controversial. Questions have recently been raised regarding the design and execution of the US Department of Veterans Affairs/National Institutes of Health Acute Renal Failure Trial Network (ATN) Study, which demonstrated no(More)
A cute kidney injury (AKI) complicates approximately 5 to 15% of hospitalizations, depending on its definition (1–3), and is independently associated with a five-fold or more increase in in-hospital mortality rates (3–5). AKI also extends length of stay, obligates excess hospital expenditures , and may exert long-term adverse effects, including an increased(More)
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