Renal failure in the intensive care unit: acute kidney injury compared to end-stage renal failure

Patients with advanced acute kidney injury (AKI) and endstage dialysis dependent renal failure (ESRF) are characterized by loss of renal function as well as significant associated co-morbidities. However, prognosis appears to differ when they are admitted to the intensive care unit (ICU). Patients with advanced AKI have a reported ICU mortality between 25% and 90%, depending on the specific patient population and the definition of AKI [1,2], whereas ICU mortality in ESRF patients has been reported to be 9% to 26% [3-5]. In contrast, Uchino and coworkers [5] found no difference in outcome between 32 ESRF patients in an ICU and 32 diagnosis and severity score matched patients with AKI treated with renal replacement therapy (RRT).