
Renal replacement therapy: Fluid Management
Renal replacement therapy: Fluid Management

Renal replacement therapy: Fluid Management

End-stage renal failure has multiple implications for ICU management

Haemoperfusion: Renal replacement therapy (RRT) using an adsorbent cartridge to remove circulating toxins

Hepatorenal Syndrome = profound oliguria and Na+ retention in the setting of severe liver dysfunction (cirrhosis or fulminant liver failure); usually fatal unless liver transplant performed. RRT can prevent advancement of condition

Renal replacement therapy (RRT): Troubleshooting

Urosepsis is a severe infection, distinguishing it from other urinary tract infections including mild pyelonephritis and accounts for ~5% of severe sepsis; whereas UTIs account for ~40% of nosocomial infections

Renal and Urological Toxicity of Chemotherapy: chronic renal failure; acute renal failure; renal tubular dysfunction; haemorrhagic cystitis; dysuria

Continuous renal replacement therapy (CRRT) is the modality most widely used in Australia and New Zealand ICUs. There is no evidence suggesting mortality benefit for one modality over another

Rhabdomyolysis is the breakdown of skeletal muscle fibres with leakage of potentially toxic intracellular contents into the systemic circulation, characterised by elevated plasma creatine kinase, myoglobinuria and risk of renal impairment

Little published data to guide dosing of antibiotics in RRT and the critically ill. therefore we must use first principles and utilize therapeutic drug monitoring if available.

Steps in preventing Continuous Renal Replacement Therapy circuits from clotting

Indications Contraindications: Choose the correct catheter Handy Hints: References and Links