Intensive Care Medicine

, Volume 30, Issue 1, pp 33–37 | Cite as

Defining acute renal failure: physiological principles

  • Rinaldo BellomoEmail author
  • John A. Kellum
  • Claudio Ronco
Physiological Note


Definitions are never “right” or “wrong”. They are simply more or less “useful” for a given purpose. The same is true of the clinical syndrome of acute renal failure (ARF), which is common in the ICU [1, 2]. In many ways, its nature and epidemiology resemble those of other loosely defined ICU syndromes, such as sepsis or ARDS. In this physiological note, however, we wish to focus on how our understanding of renal physiology can be used to guide the definition of ARF.

What are the physiological functions of the kidney?

Many renal functions are shared with other organs (acid-base control with lung; blood pressure control via the renin-angiotensin-aldosterone axis with liver, lung and adrenal glands). Other functions are not routinely measured (small peptide excretion, tubular metabolism, hormonal production) in the ICU and are not considered clinically important. There are only two physiological functions that are routinely and easily measured in the ICU, which are “unique”...


Glomerular Filtration Rate Acute Renal Failure Renal Mass Normal Glomerular Filtration Rate Baseline Glomerular Filtration Rate 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • Rinaldo Bellomo
    • 1
    Email author
  • John A. Kellum
    • 2
  • Claudio Ronco
    • 3
  1. 1.Department of Intensive Care and Division of SurgeryAustin & Repatriation Medical CentreHeidelberg, MelbourneAustralia
  2. 2.Division of Critical Care Medicine, Scaife HallUniversity of Pittsburgh Medial CentrePittsburghUSA
  3. 3.Divisione di NefrologiaOspedale San BortoloVicenzaItaly

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