The Expanding Role of the Nephrologist in the Intensive Care Unit

[摘要] In decades past, the primary role of the nephrologist in the intensive care unit (ICU) was to provide renal replacement therapy and to assist in the diagnosis and treatment of complex acid-base disorders. As the burden of kidney disease increases in our aging population, clinical nephrologists find themselves practicing more and more critical care medicine. For many nephrologists, particularly those in private practice, they are the de facto intensivist if one of their patients is admitted to the ICU. In other venues, nephrologists are able to consult on critically ill patients with a multispecialty team of treating physicians. The extent of the role placed on the nephrologist in the ICU is often determined by local practice (e.g., presence of closed or open ICU) and geography (rural versus urban). In locales where a critical care consultant is not immediately available, nephrologists are often drawn into the critical care treatment of these patients because their patients have chronic kidney disease or have developed acute kidney injury (AKI). In either scenario, the increasing complexity of the ICU demands that consulting nephrologists understand the clinical and technologic advances in critical care medicine.

[学科分类] 泌尿医学

[关键词] Bone marrow necrosis;Sickle cell disease;Hyperhemolysis syndrome