Basile Carlo, Lomonte Carlo
G Ital Nefrol. 2013 May-Jun;30(3).
Although several advantages have been attributed to continuous renal replacement therapy (CRRT), including greater hemodynamic stability permitting better fluid removal, improved recovery of renal function, and more efficient removal of small and large metabolites, none of these factors has been adequately corroborated in controlled trials. On the other hand, sustained low efficiency dialysis (SLED) has enjoyed an unsurpassed renaissance over the last decade for treatment of severely ill patients with acute kidney injury in the intensive care unit (ICU). SLED combines excellent detoxification and good cardiovascular tolerability for even severely ill patients in the ICU. SLED also provides good treatment time flexibility at lower costs than CRRT with the advantage that existing dialysis systems can be used. In conclusion, SLED represents an alternative to CRRT, enabling optimal treatment of complex critically ill patients. It can be considered a key treatment modality for patients on ICU, giving nephrologists and ICU physicians the opportunity for pooling their twin areas of expertise.
尽管持续肾脏替代疗法（CRRT）具有诸多优势，包括血流动力学稳定性更高，从而能更好地清除液体、肾功能恢复更佳以及能更有效地清除大小代谢产物，但在对照试验中，这些因素均未得到充分证实。另一方面，在过去十年中，持续性低效透析（SLED）在重症监护病房（ICU）治疗急性肾损伤的重症患者方面经历了无与伦比的复兴。SLED对ICU中病情严重的患者而言，兼具出色的解毒能力和良好的心血管耐受性。SLED还具有良好的治疗时间灵活性，成本低于CRRT，且优势在于可使用现有的透析系统。总之，SLED是CRRT的一种替代方案，能够对复杂的重症患者进行最佳治疗。它可被视为ICU患者的关键治疗方式，为肾病科医生和ICU医生提供了整合其两个专业领域知识的机会。
