The term continuous renal replacement therapy (CRRT) refers to a group of clearance techniques that have been tailored for hemodynamically unstable patients with renal failure. Although the indications for starting this type of therapy are similar to the indication used to start patients on intermittent hemodialysis (IHD), the prescription, including the duration and the intensity of clearance and fluid removal, is different.

The types of machines used for each therapy also are different. Patients with unstable hemodynamics are unable to tolerate the flow rates used to render therapy in typical dialysis patients: these patients cannot tolerate large amounts of fluid removal in a limited time, nor can they tolerate the high electrolyte and solute fluxes that accompany the higher blood flow and dialysate flow rates in IHD. Thus, it comes as no surprise that the advent of CRRT was an exciting opportunity for intensivists and nephrologists caring for critically ill...

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