Intensive careAcute renal failure in the critically illVenkataraman, Ramesh; Kellum, John AAuthor Information The CRISMA (Clinical Research, Investigation, and Systems Modeling of Acute Illness) Laboratory, Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA Correspondence to John A. Kellum MD, Room 608 Scaife Hall, The CRISMA Laboratory, Department of Critical Care Medicine, University of Pittsburgh, 3550 Terrace Street, Pittsburgh, PA 15261, USA Tel: +1 412 647 6996; fax: +1 412 647 8060; e-mail: [email protected] Current Opinion in Anaesthesiology: April 2005 - Volume 18 - Issue 2 - p 117-122 doi: 10.1097/01.aco.0000162828.51399.1b Buy Metrics Abstract Purpose of review Acute renal failure occurs frequently in hospitalized patients and is associated with significant morbidity and mortality. An effort to better understand the epidemiology and pathophysiology of this disease will hopefully lead to improvement in patient outcomes. Considerable effort has been expended to develop techniques to prevent acute renal failure or to facilitate its resolution. In this review we attempt to summarize some of these recent advances. Recent findings Attempts have been made to clearly define acute renal failure. Among the available pharmacologic agents, current evidence suggests that with the possible exception of radio-contrast-induced acute renal failure, no drugs are capable of preventing the condition or hastening its recovery. Advances in techniques and understanding of how to best provide renal replacement therapy appear to have improved patient outcomes and several newer treatments are under preclinical evaluation and may hold promise for the future. Summary Preventing acute renal failure, improving clinical outcomes of the condition and attempts to hasten renal recovery have all been very attractive but difficult propositions. Recent efforts to explore the underlying pathophysiology and insight into mechanisms leading to acute renal failure have triggered investigators to evaluate novel therapeutic agents and enhance existing dialytic techniques. These hold great promise for improving patient outcomes in the near future. © 2005 Lippincott Williams & Wilkins, Inc.