Acute Kidney Injury and Acute Respiratory Distress Syndrome

The most consistent signal for mortality in acute respiratory distress syndrome (ARDS) is multi-organ failure, specifically when it involves the kidneys. Acute kidney injury (AKI) complicates approximately a third of all ARDS cases, and the combination of the two drastically worsens prognosis. Recent advances in ARDS supportive care have led to improved outcomes, however, much less is known on how to prevent and support patients with AKI and ARDS together. Understanding the dynamic relationship between the kidneys and lungs is crucial for the practicing intensivist in order to prevent injury. In this review, we summarize key concepts for the critical care physician managing a patient with ARDS complicated by AKI, including crucial regarding renal replacement therapy. We will finally end on a discussion of AKI in the COVID-19 era.
Source: Critical Care Clinics - Category: Intensive Care Authors: Source Type: research