An official ATS/ERS/ESICM/SCCM/SRLF statement: Prevention and management of acute renal failure in the ICU patient: An international consensus conference in intensive care medicine

Laurent Brochard, Fekri Abroug, Matthew Brenner, Alain F. Broccard, Robert L. Danner, Miquel Ferrer, Franco Laghi, Sheldon Magder, Laurent Papazian, Paolo Pelosi, Kees H. Polderman

Research output: Contribution to journalArticlepeer-review

184 Scopus citations

Abstract

Objectives: To address the issues of Prevention and Management of Acute Renal Failure in the ICU Patient, using the format of an International Consensus Conference. Methods and Questions: Five main questions formulated by scientific advisors were addressed by experts during a 2-day symposium and a Jury summarized the available evidence: (1) Identification and definition of acute kidney insufficiency (AKI), this terminology being selected by the Jury; (2) Prevention of AKI during routine ICU Care; (3) Prevention in specific diseases, including liver failure, lung Injury, cardiac surgery, tumor lysis syndrome, rhabdomyolysis and elevated intraabdominal pressure; (4) Management of AKI, including nutrition, anticoagulation, and dialysate composition; (5) Impact of renal replacement therapy on mortality and recovery. Results and Conclusions: The Jury recommended the use of newly described definitions. AKI significantly contributes to the morbidity and mortality of critically ill patients, and adequate volume repletion is of major importance for its prevention, though correction of fluid deficit will not always prevent renal failure. Fluid resuscitation with crystalloids is effective and safe, and hyperoncotic solutions are not recommended because of their renal risk. Renal replacement therapy is a life-sustaining intervention that can provide a bridge to renal recovery; no method has proven to be superior, but careful management is essential for improving outcome.

Original languageEnglish (US)
Pages (from-to)1128-1155
Number of pages28
JournalAmerican journal of respiratory and critical care medicine
Volume181
Issue number10
DOIs
StatePublished - May 15 2010
Externally publishedYes

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