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Theory and practical application of blood-based renal replacement therapy
J S Murray1, W T Hinchliffe, N S Kanagasundaram
1Department of Renal Medicine, Newcastle-upon-Tyne Hospitals NHS Foundation Trust, Newcastle-upon-Tyne NE7 7DN.
This review covers blood-based renal replacement therapies, including haemodialysis, used for kidney failure and other conditions. It details the theory and practical uses of these extracorporeal treatments.
Area of Science:
- Nephrology
- Critical Care Medicine
- Biomedical Engineering
Background:
- Renal replacement therapy (RRT) encompasses treatments for renal failure.
- Peritoneal dialysis and kidney transplantation are two RRT modalities.
- This review focuses on blood-based RRT, distinct from the other two.
Purpose of the Study:
- To review blood-based renal replacement therapies.
- To outline the theory and practical applications of these treatments.
- To clarify that 'haemodialysis' is only one type of blood-based RRT.
Main Methods:
- Literature review of blood-based renal replacement therapies.
- Focus on treatments involving direct blood processing in an extracorporeal circuit.
- Discussion of theoretical principles and clinical applications.
Main Results:
- Blood-based RRT provides treatment for end-stage renal failure and acute kidney injury.
- These therapies are also used for non-renal indications like drug overdose management.
- Haemodialysis is a common but not the sole form of blood-based RRT.
Conclusions:
- Blood-based therapies are a critical component of renal replacement therapy.
- Understanding the range of blood-based treatments is essential for clinical practice.
- These therapies offer solutions for both renal and non-renal critical conditions.
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Dialysis
Acute kidney injury develops suddenly and can be caused by pre-renal causes (e.g., hypovolemia, shock), intrinsic renal causes (e.g., acute tubular necrosis), or post-renal causes (e.g., urinary obstruction). In contrast, chronic renal failure progresses gradually over time and is often...