ABSTRACT
Acute renal failure (ARF) is a common complication in critical illness. The incidence of ARF in the intensive care unit (ICU) has been reported from 1.5% to 24%, depending on populations studied and criteria used.1-5 Some of these patients do not have enough solute clearance and/or diuresis, accumulate uremic toxins and water, develop uremia and/or fluid overload, and require renal replacement therapy (RRT). One of the major problems related to RRT is that, although it supports kidneys like a mechanical ventilator does for the lungs, available randomized controlled evidence to guide clinical practice is limited. There is some consensus on how and when to initiate, cease, and withdraw mechanical ventilation.6-9 On the other hand, because of limited evidence, there is little consensus on how and when to initiate, cease, and withdraw RRT. Thus, practice variation is significant.
