title: 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.
abstract: OBJECTIVE
  To address the issues of Prevention and Management of Acute Renal Failure in the ICU Patient, using the format of an International Consensus Conference.
  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.
  
  
  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.
authors.forename: Laurent
authors.initials: L
authors.lastname: Brochard
authors.forename: Fekri
authors.initials: F
authors.lastname: Abroug
authors.forename: Matthew
authors.initials: M
authors.lastname: Brenner
authors.forename: Alain F
authors.initials: AF
authors.lastname: Broccard
authors.forename: Robert L
authors.initials: RL
authors.lastname: Danner
authors.forename: Miquel
authors.initials: M
authors.lastname: Ferrer
authors.forename: Franco
authors.initials: F
authors.lastname: Laghi
authors.forename: Sheldon
authors.initials: S
authors.lastname: Magder
authors.forename: Laurent
authors.initials: L
authors.lastname: Papazian
authors.forename: Paolo
authors.initials: P
authors.lastname: Pelosi
authors.forename: Kees H
authors.initials: KH
authors.lastname: Polderman
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control / Q000628:therapy*; D015415:Biomarkers; D003422:Critical Care / Q000379:methods; D006801:Humans; D007362:Intensive Care Units; D017410:Practice Guidelines as Topic; D018570:Risk Assessment
chemical_list: D015415:Biomarkers