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Related Concept Videos

Continuous Renal Replacement Therapy01:30

Continuous Renal Replacement Therapy

Continuous Renal Replacement Therapy, also known as CRRT, is a procedural treatment for acute kidney injury (AKI) that gradually removes uremic toxins and fluids while maintaining acid-base balance and stabilizing electrolytes. It is particularly useful for hemodynamically unstable patients. Unlike intermittent hemodialysis, which is faster, CRRT provides a gentler approach over 24 hours, closely mimicking the function of natural kidneys. However, CRRT is not ideal for patients with...
Extracorporeal Removal of Drugs: Continuous Renal Replacement Therapy01:26

Extracorporeal Removal of Drugs: Continuous Renal Replacement Therapy

Continuous Renal Replacement Therapy (CRRT) is an essential intervention for patients experiencing severe kidney dysfunction. This therapy offers a continuous mechanism for removing fluids and toxins from the bloodstream, leveraging the patient’s blood pressure to facilitate filtration through a specialized filter. This method contrasts with intermittent dialysis, providing a gentler and more consistent removal of waste products and excess fluid, which is particularly beneficial in critically...
Acute Kidney Injury V: Interprofessional Care01:20

Acute Kidney Injury V: Interprofessional Care

Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
Chronic Kidney Disease III: Interprofessional Care01:28

Chronic Kidney Disease III: Interprofessional Care

Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
Dialysis01:27

Dialysis

Renal failure occurs when the kidneys lose their ability to filter waste products from the blood effectively. It can be classified into two types: acute renal failure (ARF) and chronic renal failure (CRF).
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...

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Continuous renal replacement therapy: recent advances and future research.

John R Prowle1, Rinaldo Bellomo

  • 1Department of Intensive Care, Austin Health, Heidelberg, Vic 3084, Australia.

Nature Reviews. Nephrology
|July 21, 2010
PubMed
Summary

Continuous renal replacement therapy (CRRT) is preferred for acute kidney injury (AKI) in ICUs. However, new trials show higher CRRT doses do not improve patient outcomes, guiding clinical practice.

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Last Updated: Jun 10, 2026

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Microdissection of Primary Renal Tissue Segments and Incorporation with Novel Scaffold-free Construct Technology

Published on: March 27, 2018

Area of Science:

  • Nephrology
  • Critical Care Medicine

Background:

  • Continuous renal replacement therapy (CRRT) is widely used for acute kidney injury (AKI) in intensive care units (ICUs).
  • Lack of level 1 evidence comparing CRRT with intermittent hemodialysis (IHD) has led to practice variations.
  • Recent pivotal trials provide crucial data to inform CRRT application.

Purpose of the Study:

  • To review the background and results of the ATN and RENAL trials.
  • To discuss the emerging consensus on CRRT for vasopressor-dependent AKI patients.
  • To highlight remaining controversies and unanswered questions in CRRT use.

Main Methods:

  • Review of results from the Veterans Affairs/National Institutes of Health Acute Renal Failure Trial Network (ATN) study.
  • Analysis of data from the Randomized Evaluation of Normal versus Augmented Level Renal Replacement Therapy (RENAL) trial.
  • Synthesis of level 1 evidence regarding CRRT intensity in ICU settings.

Main Results:

  • The ATN and RENAL trials provide substantial level 1 evidence on CRRT intensity.
  • Effluent flow rates exceeding 25 ml/kg per hour in CRRT do not enhance patient outcomes in the ICU.
  • Evidence supports CRRT as the preferred treatment for AKI in vasopressor-dependent ICU patients.

Conclusions:

  • CRRT is the most appropriate treatment for AKI in critically ill, vasopressor-dependent patients.
  • Higher CRRT doses beyond a certain threshold do not offer additional survival benefits.
  • Further research is needed to address ongoing controversies and optimize CRRT protocols.