Outcomes in patients who have critical illness associated with acute renal failure have traditionally been poor. However, recent improvements in outcomes with these patients have been documented. Much of this improvement may be due to innovations in renal replacement methods and improved delivery of dialysis to critically ill patients.
As the care of patients in the intensive care unit has become increasing complex over the past two decades, the subspecialty of critical care medicine has become important. Equally important has been the development of a subspecialty within the nephrology community with a direct interest in innovative patient care and research protocols in caring for patients with renal disease associated with critical illness.
The Division of Nephrology at the Mayo Clinic created the Nephrology Critical Care Service to answer these very needs in January 1999. Innovations in patient care, education and research continue under the direction of the physicians who staff the Nephrology Critical Care Service.
Disorders of fluids, electrolytes and acid-base disorders, as well as acute renal failure, are handled by this group. The expertise of this service is limited to the intensive care units and, as a result, a relationship has been developed between the other physicians and other subspecialists practicing in the intensive care units at the Mayo Clinic.
Education opportunities for physicians have additionally been facilitated by this multidisciplinary approach to caring for the patient with acid-base or fluid and electrolyte disorders.
Specifically, newer methods of renal replacement such as continuous venovenous hemodiafiltration, continuous venovenous dialysis and hemofiltration as well as the use of charcoal hemoperfusion are being applied on a regular basis and are part of several different research protocols. Additionally, a new research study evaluating hepatic-assist devices has been initiated.
The Nephrology Critical Care Service is staffed by nephrologists who have specific interests in acute renal failure, critical care medicine, and acid-base and fluid and electrolyte disorders. Additionally, there are several members of the Nephrology Critical Care Interest Group Section who are board certified in Critical Care Medicine as well as Nephrology.