Continuous Renal Replacement Therapy In The Intensive Care Unit

3235 words - 13 pages

The renal disease are common nowadays .The acute renal failure is a medical term means that the kidneys stopped from working and not able to clear toxins from body ,not able to maintained a stable electrolyte balance inside the body and not able to secret the extra fluid as urine outside the body. The renal replacement therapy (RRT) or dialysis has been discovered on 1913 by Able, Rowntree and Turner in London, UK.
In medicine dialysis is primarily used to provide an artificial support for the lost kidney function in people with renal failure.
Currently there are two types of renal replacement therapy. The original dialysis which we called it hemodialysis used for patients with chronic renal failure, needs the patients to come to hospital 2-3 times per week. This type of dialysis called the intermittent hemodialysis .However the intermittent hemodialysis is difficult to do it in the intensive care population with acute renal failure because of the hemodynamic instability and those type of patients usually are the most sick and critically ill patients within the intensive care units and have multiorgan dysfunctions, so medically is too difficult to do for them intermittent hemodialysis. In addition intermittent hemodialysis will increase the mortality and morbidity among them. Within the modern intensive care units new way of dialysis has been developed 30 years ago called continuous renal replacement therapy (CRRT).The definition of (CRRT) is any extracorporeal blood purification therapy intended to substitute for impaired renal function over an extended period of time and applied for or aimed at being applied for 24 hours/day, Bellomo R., Ronco., Mehata R. The CRRT was found because the traditional way of dialysis required hemodynamic ally stable patients .As we know the patients in the intensive care units are very sick, hypotensive and hemodynamic ally unstable . The concept behind continuous renal replacement techniques is to dialyze patients in a more physiologic way, slowly, over 24 hours, just like the kidney. Intensive care patients are particularly suited to these techniques as they are, by definition, bed bound, and, when acutely sick, intolerant of the fluid swings associated with IHD. The CRRT provided to the patients with acute renal failure within the intensive care units only. Given the slow continuous hemodialysis nature of it, make it resembling the native kidney function. So it well tolerated by hemodynaamically unstable patients, regulate acid base balance and remove large amount of fluid and waste over time .The most common indication for initiation of (CRRT) are anuria or oliguria less than 200 ml over 24 hour, hyperkalemia more than 6.5mmol/liter, azotemia or blood urea nitrogen more than 25 mmol/liter, pulmonary odema, severe academia PH less than 7.2, uremic pericarditis and encephalopathy. About 23 % of patients in the (ICU) have acute kidney injury which usually resolved, but some of them...

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