Prescription of CRRT: a pathway to optimize therapy

Annals of Intensive Care
Ayman Karkar, Claudio Ronco

Abstract

Severe acute kidney injury (AKI), especially when caused or accompanied by sepsis, is associated with prolonged hospitalization, progression to chronic kidney disease (CKD), financial burden, and high mortality rate. Continuous renal replacement therapy (CRRT) is a predominant form of renal replacement therapy (RRT) in the intensive care unit (ICU) due to its accurate volume control, steady acid-base and electrolyte correction, and achievement of hemodynamic stability. This manuscript reviews the different aspects of CRRT prescription in critically ill patients with severe AKI, sepsis, and multiorgan failure in ICU. These include the choice of CRRT versus Intermittent and extended hemodialysis (HD), life of the filter/dialyzer including assessment of filtration fraction, anticoagulation including regional citrate anticoagulation (RCA), prescribed versus delivered CRRT dose, vascular access management, timing of initiation and termination of CRRT, and prescription in AKI/sepsis including adsorptive methods of removing endotoxins and cytokines.

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Citations

Oct 1, 2020·International Journal of Molecular Sciences·Nadezda PetejovaDavid Stejskal
Dec 2, 2020·International Journal of Environmental Research and Public Health·Hyeon-Ju Lee, Youn-Jung Son
Jan 4, 2021·Journal of Clinical Monitoring and Computing·John K LeypoldtKai Harenski
Mar 9, 2021·Seminars in Dialysis·Matthieu Legrand, Ashita Tolwani
Mar 23, 2021·Anaesthesia Critical Care & Pain Medicine·Nizar AttallahJihad Mallat
Nov 8, 2020·Nefrología : publicación oficial de la Sociedad Española Nefrologia·Xue XingFan He
May 4, 2021·Expert Review of Pharmacoeconomics & Outcomes Research·Ambrish SinghBenny Antony
Jul 17, 2021·Nature Reviews. Disease Primers·John A KellumHans-Joachim Anders
Sep 3, 2021·The International Journal of Artificial Organs·Federico NalessoLorenzo A Calò
Oct 27, 2021·Seminars in Dialysis·Etienne Macedo, Jorge Cerdá
Nov 13, 2021·Heart Failure Reviews·Naushaba MohiuddinJerry Yee

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