Evolving practices in critical care and their influence on acute kidney injury.
OBJECTIVE
This review highlights the principal advances in critical care over the past year, and discusses the impact of these advances on the diagnosis and management of acute kidney injury (AKI).


RESULTS
Recent literature has focused on assessment of volume status and fluid management, particularly in the setting of respiratory and cardiac failure. Other critical care topics are reviewed using a system-based approach.


CONCLUSIONS
The incidence of AKI appears to be increasing, and despite advances in the provision of critical care and renal replacement therapies, there has been little improvement in its associated morbidity and mortality. Nonetheless, recent advances in critical care will impact the diagnosis and management of AKI, as well as shape the future research agenda. Continued work in the fields of critical care and nephrology will undoubtedly be centered on improved biomarkers for the detection of AKI, specific therapies to mitigate or reverse AKI, and techniques to prevent the development of AKI in the critically ill population.
aDepartment of Medicine and Anesthesia, Division of Critical Care Medicine bDepartment of Medicine and Anesthesia, Divisions of Nephrology and Critical Care Medicine, University of California, San Francisco, California, USA *Jennifer G. Wilson and Brad W. Butcher contributed equally to the writing of the article.
Jennifer G
JG
Wilson
Brad W
BW
Butcher
Kathleen D
KD
Liu
D058186:Acute Kidney Injury / Q000175:diagnosis / Q000628:therapy*; D000740:Anemia / Q000628:therapy*; D000925:Anticoagulants / Q000627:therapeutic use; D003422:Critical Care / Q000379:methods / Q000639:trends; D005260:Female; D006333:Heart Failure / Q000517:prevention & control*; D006440:Hemofiltration; D006801:Humans; D015994:Incidence; D008297:Male; D017582:Renal Replacement Therapy / Q000379:methods / Q000639:trends; D012121:Respiration, Artificial / Q000379:methods / Q000639:trends; D012128:Respiratory Distress Syndrome / Q000628:therapy*; D018805:Sepsis / Q000628:therapy*
D000925:Anticoagulants