A nephrologist should be consulted in all cases of acute kidney injury in the ICU: No

Excerpt

Unlike many medical subspecialties, intensive care is not defined by a specific organ. We are not “single-organ disease specialists”. Our practice is instead defined by the acute and life-threatening nature of our patient’s conditions [1]. This leads to a wide array of diseases for which intensivists must master including various forms of shock (anaphylactic, hemorrhagic, septic, etc.), cardiac dysrhythmias, diabetic ketoacidosis, acute respiratory failure, hepatic failure, encephalopathy, seizures, sepsis, and many others. In short, anything that can be rapidly fatal or lead to serious morbidity quickly is an intensive care syndrome and intensivists are experts that manage these syndromes. Yet, many intensivists do not routinely see patients with all of these syndromes. Subspecialization of intensive care over the last 15–20 years has resulted in grouping of patients with certain conditions, e.g., neurocritical care, cardiothoracic intensive care, trauma intensive care. Thus, we are seeing the emergence of intensive care generalists and intensive care subspecialists. With this stratification has come an increasingly common scenario (whether for a generalist or subspecialist) that an intensivist is faced with a patient whose condition is unfamiliar. The prudent course in such scenarios is to consult a colleague with more experience and familiarity with the condition in question. This colleague might be another intensivist whose scope of practice includes such patients or (particularly for rare diseases) a single-organ disease specialist. …