Mr. Maddox will be started on continuous renal replacement therapy (CRRT). Describe the basic mechanisms of this therapy
What will be an ideal response?
• CRRT is a type of dialysis, or a renal replacement procedure that removes excessive and toxic by-products of metabolism from the blood, thus replacing the filtering function of healthy kidneys. CRRT is generally the mode of treatment for AKI because it will provide dialysis over a continuous period of time that will allow for a significant amount of fluid (1-2 L) to be removed.
• It is meant to slowly remove fluids and solutes while correcting the electrolyte and metabolic abnormalities associated with AKI.
• Two types of CRRT:
- Arteriovenous renal replacement therapies: continuous dialysis/hemofiltration by cannulation of an artery or vein; the patient's blood pressure is used to pump blood through the dialysis filter.
- Venovenous renal replacement therapies involve continuous dialysis/hemofiltration by a venovenous circuit and a pump to assist blood flow through the dialysis circuit.
• Venovenous renal replacement is usually used in the critical patient as the patient's blood pressure is usually unstable.
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