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How to Choose Renal Replacement Therapy in a Critically Ill Patient

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Dr Arghya Majumdar, Kolkata    29 November 2019

  • In critically ill patients a mix of diffusion and convection may be ideal.
  • Sustained low efficiency dialysis (SLED) may have better small solute clearance but not adequate volume removal.
  • SLED may be better in both regards.
  • Continuous renal replacement therapy (CRRT) is superior with regards to volume removal.
  • CRRT ensures better delivery of nutrition, is ideal in cases of raised intracranial pressure, and superior in severe hemodynamic compromise.
  • Modality of RRT needs to be tailored to the unique needs, infrastructure and economy of an individual Intensive Treatment/Therapy Unit (ITU) and the population it caters to.

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