Critical care issues in the patient with chronic renal failure

The metabolic abnormalities associated with chronic renal failure and complications of the dialysis procedure present unique challenges in critical care medicine. Understanding how renal failure impacts the development and management of cardiovascular disease, bleeding tendencies, infection, and malnutrition is necessary to provide optimal care for these patients. The recognition of ESRD as a state of chronic inflammation and increased oxidative stress ultimately should lead to more effective treatment approaches for several of the comorbid conditions common in this patient population.