CRRT (Continuous renal replacement therapies) Runs for 24/7 and it is Ideal for those with AKI and fluid overload While Dialysis Includes Hemodialysis and peritoneal dialysis happens three times a week.
What are CRRT and Dialysis?
Both CRRT and dialysis are renal replacement therapies for severe acute kidney injury in critically ill patients.
CRRT (Continuous Renal Replacement Therapy):
Runs 24/7.
Ideal for those with acute kidney injury and fluid overload.
Offers continuous fluid control.
Dialysis:
- Includes intermittent hemodialysis (IHD) and peritoneal dialysis (PD).
- IHD happens three times a week for four hours in a center.
Key Differences
- Duration:
- CRRT: Always on.
- IHD: 3-4 hours, three times a week.
- Application:
- CRRT: For unstable ICU patients.
- IHD: For stable patients or those tolerating breaks.
- Fluid Removal:
- CRRT: Slow, gradual removal is easier on critically ill patients.
- IHD: Fast removal can cause instability.
- Solute Clearance:
- CRRT: Effective over time, lower flow rates.
- IHD: Quick, higher flow rates.
Usage and Popularity
A 2015 study showed CRRT was used in 75.2% of ICU AKI cases, while IHD was at 24.1%.
Choosing Therapy
Factors include:
- Patient stability.
- Doctor’s preference and experience.
- Available resources.
- Patient specifics like illness severity.
New Options
Innovative therapies are being developed:
- SLEDD (Sustained Low-Efficiency Daily Dialysis)
- PIRRT (Prolonged Intermittent Renal Replacement Therapy)
These aim to combine CRRT’s stability with IHD’s cost-efficiency.
Conclusion
In conclusion, while both CRRT and dialysis serve to replace kidney function in critically ill patients, the choice between them depends on various clinical factors and resource availability. CRRT is often preferred for unstable patients in ICU settings, while intermittent dialysis may be more suitable for stable patients or those transitioning to long-term care.
Frequently Asked Questions (FAQs)
Acute kidney injury (AKI), Multiple organ failure, Sepsis, Severe fluid overload