Continuous renal replacement therapy is a form of dialysis administered continuously, typically twenty-four hours a day, rather than in the intermittent sessions used for standard hemodialysis, performed with a mechanical blood pump at a slow, steady flow rate. It is used chiefly in critically ill patients in intensive care whose acute kidney injury or unstable blood pressure makes them poorly suited to the faster fluid and solute shifts of intermittent hemodialysis. Nephrologist Peter Kramer introduced the underlying technique, continuous arteriovenous hemofiltration, in 1977, and it was subsequently refined into several venovenous variants that use a pump rather than relying on the patient's own arterial blood pressure, becoming a standard tool of modern intensive care.
Facts
FAQs
Why is continuous renal replacement therapy often chosen for critically ill patients instead of standard hemodialysis?
Its slow, round-the-clock fluid removal potentially causes less hemodynamic instability than short intermittent hemodialysis sessions.
Standard intermittent hemodialysis does its work over a short period, typically three to five hours, and that rapid fluid removal and shift in solutes may worsen hemodynamic instability in critically ill patients. Continuous renal replacement therapy removes fluid and clears solutes continuously, twenty-four hours a day, which potentially allows for less hemodynamic instability. The choice is not settled in favor of one mode: one intensive care physician's review argues that the useful question is which patient needs which mode and when, and that many patients begin on the continuous therapy and move to intermittent hemodialysis once they are hemodynamically stable and need to be mobilized.
Connections
Sources
1. Wikipedia
Wikipedia contributors, Wikimedia Foundation
2. Continuous Renal Replacement Therapy (Wikipedia)
Wikimedia FoundationHistory sectionQuote, History section
Continuous hemofiltration (CHF) was first described in a 1977 paper by Kramer et al. as a treatment for fluid overload.
Wikipedia: Hemofiltration
Wikipediahttps://en.wikipedia.org/wiki/Hemofiltration, lead section
Hemofiltration, also haemofiltration, is a renal replacement therapy used in the intensive care setting.
In Group: Dialysis and Renal Replacement Therapy, Introduction, sentence 1
Hemofiltration, also haemofiltration, is a renal replacement therapy used in the intensive care setting.
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