The tale of intensive care and renal replacement therapy

Abstract

Renal replacement therapy and intensive care have a common history. Initially, their objective was to fight off death because of single-organ failure. This first objective being reached, more complex patients with multiple organ failure became the next challenge. The unique opportunity to control homeostasis through a direct access to the vascular compartment extended the potential therapeutic applications of hemodialysis beyond renal replacement. Finally, recent studies having established the situations where hemodialysis is indicated in intensive care patients, it is now the time to set renal resuscitation objectives for long-term nephrological outcomes. We delineate here the successful development of intensive care and renal replacement therapies in parallel and the remaining challenges.