Critical Care Nephrology: A Multidisciplinary Approach

Acute kidney injury (AKI) is a serious medical condition affecting millions of people. Patients in intensive care unit (ICU) who develop AKI have increased morbidity and mortality, prolonged length of stay in ICU and hospital and increased costs, especially when they require renal replacement therapy. In the latter case, morbidity and mortality increase further. In order to meet the needs of the critically ill patients, a multidisciplinary care team is required, combining the efforts of physicians and nurses from different disciplines as well as nephrologists and intensivists. A personalized patient management is strongly recommended as proposed by the recent criteria of precision medicine. Early identification of patients at risk and timely intervention in case of AKI diagnosis can be obtained by integrating the role of nephrologist in the ICU practice. An innovative model of organization by introducing the nephrology rapid response team is advocated to manage critically ill patients with kidney problems in order to make early diagnosis and interventions, to reduce progression toward CKD and improve renal recovery. The routine adoption of AKI biomarkers together with such a collegial teamwork may represent the pathway toward success.