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CRRT for Acute Renal Failure

2012-09-12 17:57

More than 1/3 of all patients admitted to intensive care unites will experience acute renal failure. Hemodialysis is always the primary treatment, but the rapid fluid and electrolyte shifts is not tolerable for hemodynamically unstable patients. This is when CRRT (Continuous Renal Replacement Therapy) is ordered. In other words, CRRT is designed to provide artificial kidney support to patients who cannot tolerate traditional hemodialysis.

Acute Renal Failure

Acute renal failure, also known as acute kidney injury, refers to that your kidneys have suddenly stopped working. Our kidneys remove waste products and help balance water and salt and other minerals in our blood. If kidneys fail to function suddenly, the toxins, fluids and electrolytes build up in the blood, causing deadly problems. The important step for Acute Renal Failure treatment is to clean your blood.

Why choose CRRT?

If you happen to be a person with acute renal failure and cannot tolerate the rapid fluid and electrolyte of traditional hemodialysis, CRRT (continuous renal replacement therapy) specially works for you. CRRT provides slow and balanced fluid removal that even unstable patients—those with shock or severe fluid overload—can more easily tolerate. Both average and smaller size patients can undergo CRRT and it can adapted quickly to meet changing needs.

What types of CRRT are there?

There are 4 types of CRRT, that is, slow continuous ultrafiltration (SCUF), continuous venovenous hemofiltration (CVVH), continuous venovenous hemodialysis (CVVHD), continuous venovenous hemodiafiltration (CVVHDF).

SCUF removes fluid without the need for replacement fluids, which prevents or treats fluid overload in cases when waste products don’t need to be removed, or the pH levels don’t need to be corrected.

CVVH works to eliminate the large volumes of fluids and waste from the blood, which then utilizes replacement fluids that are devoid of toxins to keep electrolyte and acid base balance.

CVVHD uses diffusion along with dialysate solution to boost the waste products removal.

CVVHDF not only can remove the large volumes of wastes and fluids, but also cleansing fluid and replacement fluids are used to replace the dirty plasma with clean fluid. It can remove large volumes of toxin-filled plasma and still keep the electrolyte balance.

Conditions Requiring CRRT

Besides acute kidney failure, CRRT has also proven beneficial in cases of drug toxicity, the conditions requiring CRRT includes:

- hyperthermia

- uremic Pericarditis

- uremic myopathy

- severe dysnatraemia (sodium>160 or <115mmol/L)

- uremic encephalopathy

- drug overdose with dialyzable toxin

- Anuria (less than 59ml in 12 hours)

- Oliguria (200ml in 12 hours)

- Hyperkalaemia (potassium >6.5mmol/L)

- Severe acideaemia (PH<7.1)

Compared with other blood dialyzer, CRRT gives rapid and constant blood flow rate, which improves life quality of hemodynamically unstable patients. In addition, it helps deals with various emergency conditions.

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