Key messages

• Patients with chronic renal failure must be considered as having a multisystem disease which is likely to complicate their management following admission to the intensive care unit.

• The aims of management are twofold: firstly, conservation of renal function since any further loss is often irrecoverable; secondly, protection of the patient from underlying cardiovascular disease, coagulopathy, and predisposition to gastrointestinal hemorrhage.

• Other factors, such as malnutrition, immune depression, and endocrine and metabolic abnormalities, can complicate both diagnosis and management.

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