ABSTRACT
In healthy individuals, the kidney serves the dual function of eliminating waste products and
controlling fluid balance. Critically ill patients frequently sustain a loss of one or both of
these renal functions and require support with dialysis. Dialysis therapy is initiated when
the level of waste products in the blood is toxic, or when fluid balance cannot be maintained
with the aggressive use of diuretics. The major indications for emergency dialysis include
fluid overload that compromises oxygenation, hyperkalemia that cannot be managed with
ion-exchange resins or diuretics, uncontrollable bleeding not attributable to a cause other
than uremia, or anuria. Additional indications are summarized in Chapter 34.
