Diagnostic Strategies for Renal Impairment in the Intensive Care Unit

In the intensive care unit (ICU), most patients with high level of serum creatinine are now considered to have acute kidney injury (AKI). AKI results from several systemic aggressors such as sepsis, shock, or nephrotoxic drug. However, this may not be true in all patients. Indeed some ICU patients may suffer from a more specific form of acute renal failure. Prompt diagnosis and treatment are crucial for the prognosis of these patients. The aim of this article is to present an overview of renal failure that can be encountered in the ICU setting. It also aims at suggesting a diagnostic strategy taking into account the specificity of the ICU patients. Finally, the indications of renal biopsy in the critically ill patients are discussed.