Fluid resuscitation and the septic kidney

Acute renal failure is a common complication of sepsis in the critically ill patient. Fluid resuscitation is considered a cornerstone for preservation of function in the septic kidney. This is generally based on the assumption that fluid therapy will restore and maintain adequate renal blood flow. This principle, however, has not yet been formally evaluated in humans. Thus, it remains unclear how fluid therapy may affect renal blood flow in septic acute renal failure. Further, there is new evidence to imply that the choice, timing and amount of fluid used for resuscitation in sepsis may have a direct impact on kidney function. Thus, in this editorial, we consider the relevant literature and more recent insights into the effect of fluid resuscitation on the septic kidney.