The Acute Dialysis Quality Initiative--part IV: membranes for CRRT

The extracorporeal membrane used in a continuous renal replacement therapy (CRRT) for the treatment of a critically ill patient with acute renal failure (ARF) is vitally important for several reasons, including its influence on biocompatibility and filter performance. The clinical relevance of membrane-related biocompatibility markers traditionally used in chronic hemodialysis remains unclear in CRRT. Numerous approaches may be used to assess membrane and filter performance in CRRT, but no specific methodology is accepted widely at present. Although a potential benefit of certain membranes used for CRRT is adsorptive removal of inflammatory mediators, this issue has not been assessed carefully in well-designed clinical trials. These and other issues should be the subject of future clinical research efforts.