Saunders Hollie, Rehan Anam, Hashmi Muhammad F., Sanghavi Devang K.
Thomas Jefferson University Hospital
National Health Service
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).
有多种肾脏替代疗法（RRT）可用于治疗严重急性肾损伤（AKI），包括间歇性血液透析（IHD）、连续性肾脏替代疗法（CRRT）和延长的间歇性RRT。关于治疗技术的决策取决于透析指征、临床医生的偏好、预后数据，以及最重要的血流动力学状态。一项2015年针对重症监护病房（ICU）中AKI患者的跨国横断面流行病学研究显示，在75.2%的治疗时段中，CRRT是首选的治疗方式，相比之下，24.1%的治疗时段采用间歇性透析，0.7%的治疗时段采用腹膜透析。CRRT包括在24小时内管理溶质清除和液体平衡的技术。CRRT通过半透膜利用各种溶质转运机制过滤血液。具体机制定义了每种CRRT类型。三种CRRT技术分别是连续性静脉-静脉血液滤过（CVVH）、连续性静脉-静脉血液透析（CVVHD）和连续性静脉-静脉血液透析滤过（CVVHDF）。
