Defining acute renal failure: physiological principles
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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”...
KeywordsGlomerular Filtration Rate Acute Renal Failure Renal Mass Normal Glomerular Filtration Rate Baseline Glomerular Filtration Rate
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