Continuous Renal Replacement Therapy: Who, When, Why, and How

Chest. 2019 Mar;155(3):626-638. doi: 10.1016/j.chest.2018.09.004. Epub 2018 Sep 25.

Abstract

Continuous renal replacement therapy (CRRT) is commonly used to provide renal support for critically ill patients with acute kidney injury, particularly patients who are hemodynamically unstable. A variety of techniques that differ in their mode of solute clearance may be used, including continuous venovenous hemofiltration with predominantly convective solute clearance, continuous venovenous hemodialysis with predominantly diffusive solute clearance, and continuous venovenous hemodiafiltration, which combines both dialysis and hemofiltration. The present article compares CRRT with other modalities of renal support and reviews indications for initiation of renal replacement therapy, as well as dosing and technical aspects in the management of CRRT.

Keywords: acute kidney injury; continuous renal replacement therapy; dialysis; hemodialysis; hemofiltration.

Publication types

  • Review

MeSH terms

  • Acute Kidney Injury / therapy*
  • Continuous Renal Replacement Therapy* / methods
  • Continuous Renal Replacement Therapy* / standards
  • Critical Illness / therapy
  • Humans
  • Patient Selection