In intensive care, no organ fails alone- listen to the kidneys! 

Acute kidney injury (AKI) is not a complication at the margins of intensive care — it is central to it. Around 75% of patients admitted to the Intensive Care Unit (ICU) will develop AKI during their stay, and approximately 10% will require renal replacement therapy (RRT). These figures alone make kidney dysfunction a core competency for every intensivist. Early recognition, anticipation of deterioration and timely, appropriate support are fundamental to high-quality ICU practice.

Yet in 2026, we know that AKI is not a single entity. While the diagnostic criteria remain based on serum creatinine and urine output, the biological and clinical realities differ significantly. For instance, sepsis-associated AKI is not obstructive AKI; haemodynamic instability does not carry the same implications as intrinsic kidney injury; AKI from a cardio-renal syndrome is different from the AKI of a hepato-renal syndrome.  Management must reflect this heterogeneity. The same applies to RRT: it is not a uniform intervention but a tailored therapy. Timing, modality, dose and anticoagulation should be adapted to the individual patient — precision medicine applied at the bedside.

We invite you to share the accompanying video widely and use it to reinforce kidney-focused care in your ICU — from early detection of AKI to patient-tailored RRT strategies. Because in intensive care, no organ fails in isolation — and neither should our approach to managing them!