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What is renal replacement therapy (RRT)?

When is RRT appropriate for hyperkalemia?

Although rigid thresholds based on level of serum potassium cannot be provided, RRT solely for the management of hyperkalemia is rarely appropriate when the potassium level is < 6 mmol/L. Conversely, RRT is generally appropriate in patients in whom the potassium level remains > 6.5 mmol/L despite medical management.

What are the usual indications for RRT?

The usual indications for RRT can be summarised using the UFAKE mnemonic. These indications can be 'renal' or 'non-renal'.

How should initiation and discontinuation of RRT be framed?

Discussions of initiation and discontinuation of therapy with patients and/or their family/surrogate decision-makers should be framed in light of the overall prognosis and goals of care, and need to consider other life-sustaining treatments in addition to RRT.

In acute hepatic failure, when should RRT be used?

Renal replacement therapy (RRT) should be considered when managing fluid overload, hyperthermia, and toxicity related to acute hepatic failure or drugs. RRT is usually continued until the patient shows evidence of recovery of native renal function.

When should RRT be continued?

RRT should be continued until the serum methanol concentration is < 25 mg/dL and the anion-gap metabolic acidosis and osmolal gap are normal. Additionally, RRT should be continued until the ethylene glycol level is <20 mg/dL and metabolic acidosis or other signs of systemic toxicity have been resolved.

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Renal replacement therapy Indications • LITFL • CCC Renal

Rhabdomyolysis (usually RRT is only used when renal impairment occurs) MARS ("liver dialysis") TIMING. Starting RRT. in general, RRT is started when one of the above indications is met; However, the precise timing of initiation of RRT in critically ill patients is an area of controversy (see below) Stopping RRT depends on multiples factors:

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Renal replacement therapies in critical care

The principal methods of providing renal replacement therapy (RRT) are peritoneal dialysis (PD), intermittent haemodialysis (IHD) and continuous renal replacement therapy (CRRT). Each method has advantages and limitations …

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Renal replacement therapy

OverviewTypesHistory of Continuous Renal Replacement TherapyEthical discussionsSee alsoExternal links

Renal replacement therapy (RRT) is therapy that replaces the normal blood-filtering function of the kidneys. It is used when the kidneys are not working well, which is called kidney failure and includes acute kidney injury and chronic kidney disease. Renal replacement therapy includes dialysis (hemodialysis or peritoneal dialysis), hemofiltration, and hemodiafiltration, which are various ways of filtration of blood with or without machines. Renal replacement therapy also includes kidney transplantation

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