Abstract
The optimal choice of modality for acute renal replacement therapy is unclear at present. Diffusive therapy (hemodialysis) removes small solutes mainly, whereas convective therapies (hemofiltration and hemodiafiltration) may also eliminate larger molecules such as myoglobin or cytokines. Conversely, convective therapies might predispose patients to filter clotting and thus increased costs. A systematic review and meta-analysis of clinical trials could not find evidence for clinical benefits of either modality. Thus, the decision on renal replacement therapy modality still is based on the clinical status of the individual patient, the expertise of the medical and nursing staff, and local circumstances and availability.
Highlights
The optimal choice of modality for acute renal replacement therapy is unclear at present
An area of particular uncertainty is the choice between hemodialysis, hemofiltration, or hemodiafiltration
All three modalities can be performed on a modern continuous renal replacement therapy (RRT) machine with a few simple modifications of the setup, some major technical differences do exist
Summary
The optimal choice of modality for acute renal replacement therapy is unclear at present. The strategy for renal replacement therapy (RRT) in patients with acute kidney injury (AKI) remains controversial. Crucial questions such as the optimal timing, treatment intensity, and modality for acute RRT have not found definitive answers from adequately powered prospective randomized controlled trials (RCTs).
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
