Renal Replacement Therapy For Acute Kidney Injury In Adults

The management of patients with acute kidney injury (AKI) is supportive, with renal replacement therapy (RRT) indicated in patients with severe kidney injury. Multiple modalities of RRT are available. Despite these varied techniques, mortality in patients with AKI remains high, exceeding 40 to 50 percent in severely ill patients.

The optimal timing, type of modality, and dosing strategy for patients with AKI who require RRT is reviewed here. URGENT INDICATIONS Accepted urgent indications for RRT in patients with AKI generally include: Refractory fluid overload Severe hyperkalemia (plasma potassium concentration >6.5 mEq/L) or rapidly rising potassium levels Signs of uremia, such as pericarditis, encephalopathy, or an otherwise unexplained decline in mental status Severe metabolic acidosis (pH <7.1) Certain alcohol and drug intoxications TIMING OF ELECTIVE INITIATION Elective RRT…