Background: Acute renal failure is common in critically ill patients and is associated with a high mortality rate. This paper reviews current management of patients with acute renal failure admitted to an intensive care unit.
Material and methods: Literature search in databases (Medline, Cochrane database of systematic reviews, UpToDate).
Results: The prevalence of acute renal failure is 5-20 % in patients admitted to intensive care units; the associated hospital mortality is 30-60 %. The aetiology is usually multifactorial; inflammation (sepsis, surgery), hypovolaemia and drug toxicity commonly precipitate acute renal failure. There is no effective drug treatment, but early onset of renal replacement therapies with haemodialysis or haemofiltration is likely to prolong survival.
Interpretation: Despite modern intensive care, mortality is high in acute renal failure and preventive measures should therefore be vigorously pursued. Haemodialysis and haemofiltration should be introduced early in acute renal failure, and should be available in all intensive care units.