Renal replacement therapy

idk what they want us to know.

indications for urgent RRT

  • acidosis
  • electrolytes → refractory hyperkalaemia
  • intoxication → Lithium
  • overload → refractory fluid overload
  • uraemia e.g. uraemic pericarditis
    • you don't filter for creatinine

what RRT does

  • fluid and solute removal

what RRT doesn't do

  • restore cardiac function....

modalities of CRRT (excluding SLED?)

ICU uses CRRT rather than intermittent RRT because:

  • slower flow rates
  • slower fluid removal
  • more stable acid/base + electrolyte balance

Water moving across membrane along hydrostatic pressure gradient by

  • convection
  • diffusion

haemodialysis

filter

HDF

Single organ support = dialysis unit
Multiorgan failure = ICU
Good luck

considerations in CRRT

  • anticoagulation
    • citrate → preferred, familiar
      • avoid in liver failure
      • can elevate lactate
    • heparin
    • epoprostenol
      • mind its effects on pulm vasculature... or is that what you want?

#renal #icu #incomplete