Critical Care Nephrology

Abstract

The care of the critically ill with kidney disease represents a growing proportion of patients treated by nephrologists in the hospital. As a result, critical care nephrology, melding together the expertise of nephrologists and intensivists, has emerged as a distinct subdiscipline during the past decade.1–3 Critical care nephrology is a topic at national and international meetings, has a proposed core curriculum for trainees,4 and even has its own textbook5; however, a casual perusal of the literature in critical care nephrology rapidly reveals an almost exclusive focus on issues pertaining to acute kidney injury (AKI) with relative neglect of the patient with ESRD and superimposed critical illness. In a nearly 1800-page textbook of critical care nephrology, discussion of critically ill patients with ESRD are covered in fewer than a dozen pages.5 The need for critical care nephrology to broaden its perspective and provide increased focus on patients who have ESRD and are critically ill is highlighted by the findings of Strijack et al. in this issue of JASN. 6 Using a prospectively maintained database of all adult …