Continuous Renal Replacement Therapy: Forty-year Anniversary.

Area of Science:

• Nephrology
• Critical Care Medicine
• Biomedical Engineering

Background:

• Continuous arteriovenous hemofiltration (CAVH) was introduced in 1977, offering an alternative to dialysis for critically ill patients.
• Limitations of CAVH drove innovation, leading to continuous veno-venous hemofiltration (CVVH) and hemodialysis (CVVHD).
• Industry partnerships accelerated the development of sophisticated equipment for continuous renal replacement therapies (CRRTs).

Purpose of the Study:

• To trace the technological evolution of CRRTs over 40 years.
• To highlight the expanding applications of extracorporeal therapies.
• To discuss the impact of recent advancements like information technology and precision medicine on CRRT.

Main Methods:

• Historical review of CRRT development and technological advancements.
• Analysis of research exploring expanded applications of extracorporeal therapies.
• Examination of the influence of new guidelines, information technology, and precision medicine on CRRT.

Main Results:

• CRRT technology has progressed significantly, enhancing accuracy and performance.
• Extracorporeal therapies now support cardiac, liver, and pulmonary functions, and are used for sepsis and intoxication.
• New guidelines, IT, and precision medicine are shaping the future of CRRT, enabling data collection and practice pattern evaluation.

Conclusions:

• CRRTs have matured over 40 years, demonstrating substantial progress in critical care.
• Ongoing technological evolution and research promise further advancements and improved patient outcomes.
• CRRTs remain a dynamic field with considerable potential for future innovation and application.