Continuous Renal Replacement Therapies of Acute Renal Failure and the Polyamide Membrane

Pharmacokinetics of a loading dose of amikacin in septic patients undergoing continuous renal replacement therapy

“…CRRT would therefore be able to remove the aminoglycoside at a rate equivalent to a CL Cr of 10-40 mL/min [20]. Drug removal is expected to be greater in CVVHDF than continuous venovenous haemofiltration (CVVH), but total CL may also depend on the CRRT device characteristics (surface area, haemofilter) and operating conditions (pre-dilution, post-dilution, ultrafiltration and/or dialysate flow rates) [5].…”

“…clinical management of septic patients as, in contrast to standard haemodialysis, it provides similar removal of solutes without adversely affecting cardiovascular stability [5,6]. However, there are relatively few publications regarding antibiotic dosing during CRRT in critically ill patients, and dosing of antibiotics based on predicted clearances yields only rough estimates [7].…”

Trends in Dialysis Modality for Individuals with Acute Kidney Injury

“…Our results determined the modality of RRT for AKI using claims billing and demonstrate that the greatest use of CRRT occurred in 2005, accounting for 18.3% of RRT for AKI. Although the influence of Ranco and Schiffl's papers [8,13,18] does not seem to have changed the dominant utilization of IHD in critically ill patients in the United States, the increase in the trend of CRRT may be Abbreviations: OR = odds ratio, CI = confidence interval, CRRT = continuous renal replacement therapy, DHD = daily intermittent dialysis, IHD = intermittent hemodialysis, ASHD = atherosclerotic heart disease, CHF = congestive heart failure, PVD = peripheral vascular disease, GI = gastrointestinal diseases, HTN = hypertension. a reflection of initiation of continuous modality in a growing subgroup of sicker patients with multiple medical problems, and the decrease in trend of DHD may partially be explained by a fairly reciprocal increase in use of CRRT.…”

“…[12] A number of new randomized controlled trials have challenged differing survival benefits for various RRT modalities. Until recently, it had been suggested that greater dialysis clearance either by CRRT or daily hemodialysis [8,13] was associated with improved patient survival compared to conventional dialysis patterns. More recently, in 2008, the Acute Renal Failure Trial Network (ATN) showed no decreased mortality, improved recovery of kidney function, or reduced rate of nonrenal organ failure in intensive renal support in critically ill patients as compared to a less intensive therapy.…”

Continuous Renal Replacement Therapies in Patients with Severe Sepsis and Septic Shock

“…However, hypotension, due in part to rapid fluid and solute removal, is one of the most common complications with this technique, making it less desirable in the patient who is hypotensive or hemodynamically unstable. In contrast, the rate of fluid and solute removal is slow and hypotension is less common with the CRRTs, such as continuous arteriovenous hemofiltration or hemodialysis (19)(20)(21)(22). A review of the characteristics of the different types of CRRT is available elsewhere.…”