Acknowledging differences in Acute Kidney Injury: a complex clinical syndrome in critically ill patients

In the Netherlands, approximately 80,000 people (1 per 200 inhabitants) are admitted to an intensive care unit (ICU) every year. The reasons for IC admission can be very different; after major surgery, a major accident or, for example, an infection. Despite all possibilities regarding treatment and support, IC patients are at risk for organ failure. The kidneys are very susceptible to this failure. IC patients whose kidneys fail have an increased risk of death, not only during ICU admission, but also (long) afterwards. This thesis shows that it is difficult to predict the occurrence of renal failure during ICU admission. This is probably explained by the large differences in the characteristics of patients with renal failure, with different underlying causal mechanisms for renal failure. This differences also seem to explain that the occurrence of acute renal failure in IC patients cannot be prevented or reduced in severity by measures that are the same for all IC patients.