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. Author manuscript; available in PMC: 2018 Jan 1.
Published in final edited form as: Blood Purif. 2016 Dec 3;43(1-3):68–77. doi: 10.1159/000452317

Table 1.

Practical considerations of the role of the critical care nephrologist

Programmatic aspects of Critical Care Nephrology

  • Ensure that review of potential safety events is discussed and addressed.

  • Clearly defining the roles of each member of the delivery of critical care nephrology team.

  • Engagement in hospital leadership to secure the resources necessary to provide the program with the tools/personnel to succeed.

  • Formation of a hospital wide leadership team, including nursing and pharmacy personnel, nephrology and ICU personnel participation. This strong and engaged multidisciplinary core team should be accountable for quality, cost, outcomes, and training of staff.

  • Establishment of policies for all critical care nephrology procedures in the ICU.

  • Developing a regular systematic process to assess the delivery of critical care nephrology procedures.

  • Determining the CRRT hardware necessary for care.

  • Support, encourage, model robust communication between nephrology & ICU teams regarding daily goals of acute RRT

Care of critically ill patients

  • Evaluate the etiology of AKI.

  • Implement strategies to mitigate extent of injury.

  • Prevent further injury from nephrotoxic medications.

  • Treat complications.

  • Prevent further fluid overload.

  • Provide timely, safe, and effective renal support therapy.

  • Address nutrition and drug dosing in context of renal failure and RRT.

Education of the ICU team

  • Engage in continuing medical education symposiums.

  • Educate clinical team on issues related to care of patient with AKI:

    • Fluid provision.

    • Avoidance of nephrotoxicity.

    • Appropriate drug and nutrition dosing.

    • Non-dialytic management of critically ill patients with AKI.

    • Technical aspects on different types of renal support therapy.

    • Implications on the long-term renal outcomes after AKI.

    • Role of novel biomarkers in the care of patients at risk of AKI.

  • Educate clinical team on issues related to care of patient with ESRD:

    • Medications

    • Vascular access

    • Immunosuppressive therapies

  • Educate hospital leadership:

    • Institutional and financial implications of AKI

    • Implications on the long-term outcomes after AKI

  • Development of Critical Care nephrology curriculum for nurses and house staff.