Continuous Renal Replacement Therapy

Various renal replacement therapies (RRTs) are available for managing severe acute kidney injury (AKI), including intermittent hemodialysis (IHD), continuous renal replacement therapy (CRRT), and prolonged intermittent RRT. Decisions about technique are dictated by the dialysis indication, clinician preference, outcome data, and, most importantly, hemodynamic status. A 2015 multinational cross-sectional epidemiological study of patients with AKI in intensive care units (ICUs) revealed that CRRT was the preferred treatment modality in 75.2% of sessions, compared to intermittent dialysis in 24.1% of sessions and peritoneal dialysis in 0.7% of sessions. CRRT comprises techniques that manage solute removal and fluid balance over 24 hours. CRRT filters blood through a semipermeable membrane using various solute transport mechanisms. The specific mechanism defines each CRRT type. The 3 CRRT techniques are continuous venovenous hemofiltration (CVVH), continuous venovenous hemodialysis (CVVHD), and continuous venovenous hemodiafiltration (CVVHDF).