Acute Kidney Injury and Delirium: Kidney–Brain Crosstalk

  • R. Y. Y. Wan
  • M. OstermannEmail author
Part of the Annual Update in Intensive Care and Emergency Medicine book series (AUICEM)


Delirium is widely recognized as a form of fluctuating dysfunction of the brain and occurs in up to 70% of the critically ill [1]. It is associated with increased morbidity, longer hospital stay, cognitive decline with associated loss of quality of life, and death [1–4]. Recognition of delirium remains a challenge. Completion of delirium screening involves first using a validated sedation scale to assess eligibility for cognitive assessment, followed by a validated delirium screening tool. This may not be possible to complete if patients are in a coma, unable to understand the language or have established cognitive dysfunction (e.g., dementia, mental disorders) [5, 7]. Furthermore, delirium assessments will only reflect the cognitive state of the patient at the time of the assessment, making it difficult to capture this fluctuating cognitive disorder. As a result, the prevalence of delirium is likely to be underestimated. Furthermore, with no proven effective pharmacological therapy, delirium in the critically ill continues to pose a healthcare burden and a management conundrum for clinicians [8–10].


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of PharmacyGuy’s & St Thomas’ NHS Foundation TrustLondonUK
  2. 2.Departments of Critical Care and NephrologyKing’s College London, Guy’s & St Thomas’ NHS Foundation TrustLondonUK

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