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Continuous renal replacement therapy in critically ill patients.

C Ronco1, R Bellomo, Z Ricci

  • 1Divisione di Nefrologia, Ospedale San Bortolo, Vicenza, Italy.

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|August 18, 2001
PubMed
Summary

Continuous renal replacement therapies (CRRT) offer advanced treatment for acute renal failure in critically ill patients. These therapies effectively manage multiple organ failure, particularly in septic patients, by removing inflammatory mediators.

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Area of Science:

  • Nephrology
  • Intensive Care Medicine
  • Critical Care

Background:

  • Acute renal failure (ARF) is an evolving syndrome with newly understood pathogenetic mechanisms.
  • ARF is increasingly recognized as a component of multiple organ failure (MOF), often occurring in intensive care units.
  • Sepsis is a common cause of MOF and ARF in critically ill patients.

Purpose of the Study:

  • To review the advancements in therapeutic approaches for ARF, particularly in the context of MOF.
  • To highlight the role and efficacy of continuous renal replacement therapies (CRRT) in managing critically ill patients with ARF.
  • To explore the potential of CRRT in treating non-renal indications, including MOF in septic patients.

Main Methods:

  • Review of recent developments in hemodialysis and artificial renal replacement therapy.

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  • Focus on technological advancements in machines, automation, and monitoring for enhanced efficiency and tolerance.
  • Discussion of the application and benefits of continuous renal replacement therapies (CRRT).

    • Main Results:

    • Technological progress has led to more efficient and clinically tolerable artificial renal replacement therapies.
    • Continuous renal replacement therapies (CRRT) are now feasible, safe, and effective for critically ill patients.
    • CRRT shows promise in managing multiple organ dysfunction syndrome in septic patients through potential removal of proinflammatory mediators.

    Conclusions:

    • Continuous renal replacement therapies (CRRT) represent a significant advancement in treating acute renal failure in critically ill patients.
    • CRRT is particularly effective in managing multiple organ failure associated with sepsis.
    • CRRT may modulate immune responses and systemic inflammation, potentially restoring homeostasis in critically ill patients.