Special Feature Evolving Practices in Critical Care and Potential Implications for Management of Acute Kidney Injury

A cute kidney injury (AKI) is a common complication inhospitalized patients, with an incidence of 3 to 10%(1–4). In-hospital mortality rates that are associated with AKI remain high, in the range of 30 to 70 % (5–8), despite significant improvements in dialytic technology as well as im-portant advances in critical care, which have resulted in im-proved survival for other critical illnesses, including acute lung injury and sepsis (9). These improvements include continuous renal replacement therapies, which allow for continuous re-moval of solutes and fluid and may be tolerated better from a hemodynamic standpoint, and biocompatible dialysis mem-branes, which are associated with reduced complement and granulocyte activation. In general, indications for dialysis in the acute care setting have been extrapolated from those that are applied in chronic kidney disease, including volume overload that is refractory to diuretic therapy; electrolyte abnormalities (in particular hyper