Six Truths about Acute Kidney Injury that the Intensivist Should Be Aware Of

  • E. A. J. Hoste
Conference paper


Intensive care medicine has its roots in the care of patients with respiratory insufficiency, and hemodynamic impairment. Since the 1950s, the pioneer years of critical care medicine, intensivists filled the gap in knowledge and workforce that was left open by traditional medical specialties such as surgery and medicine. However, some aspects of the care of critically ill patients were still covered by non-intensivists, and sometimes they still are. Examples of this are infectiology, liver failure, and acute kidney injury (AKI). The most important reason for this is probably a pragmatic one. Specialists in infectiology, acute liver disease, and AKI had the knowledge to care for these diseases in critically ill patients, and were also willing to invest time in this. For the care of patients with AKI, there is another important economic reason, nephrologists already had the necessary infrastructure, dialysis machines, and nurses, to treat these patients. Consequently, the critical care medical literature focuses on ‘traditional’ topics, and less on these ‘specialized’ issues. Since the introduction of continuous renal replacement therapy (CRRT), at the end of the 1980s, intensivists also became more interested in AKI. This is maybe best illustrated by the foundation of the Acute Dialysis Quality Initiative (ADQI, in August 2000 [1]. ADQI is an organization where nephrologists and intensivists specialized in the care for patients with AKI collaborate. This group set itself, as an important goal, to summarize the existing evidence on AKI treatment and on the basis of this summary to formulate recommendations for treatment and further research. One of the important accomplishments of the ADQI is the introduction of a consensus definition of AKI, the RIFLE classification [2].


Acute Renal Failure Renal Replacement Therapy Acute Kidney Injury Sodium Bicarbonate Serum Creatinine Concentration 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer Science + Business Media Inc. 2008

Authors and Affiliations

  • E. A. J. Hoste
    • 1
  1. 1.Surgical Intensive Care Unit, 2k12-CGhent University HospitalGentBelgium

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