What are the Important Considerations in the Care of Critically III Patients with Acute Renal Failure?

With the recent progress in molecular and cellular biology, the 1990s present a unique opportunity for understanding the cellular or humoral factors responsible for accelerated catabolism in ARF. This author believes that a greater priority should be placed on funding basic research directed at understanding the pathogenesis of protein catabolism in ARF. For example, identifying the intracellular pro‐teolytic pathways which are activated in experiment& ARF might lead to strategies to suppress accelerated proteolysis. Insight gained from these efforts could then be used to design clinical trials to test the efficacy of nutritional interventions in this patient population. In this era of increased economic constraints, practical solutions to this formidable problem are needed.