CRRT primer

Question 1

What is CRRT and how does it compare to regular hemodialysis?

Answer 1

CRRT is a form of dialysis is run continuously over 24 hours. It provides a more gentle solute (waste) and fluid removal.

Question 2

Is what population is CRRT used?

Answer 2

CRRT is usually used in critically ill patients with kidney failure who are unable to tolerate standard dialysis due to the stress it puts on the body.

Question 3

How many critically ill patients have AKI?

Answer 3

About 65%

Question 4

What is the mortality rate in critically ill patients with AKI?

Answer 4

Greater than 50%

Question 5

What is the chance of kidney recovery in critically ill patients with AKI who initially had healthy kidneys?

Answer 5

Greater than 90%

Question 6

Once CRRT is started, how do clinicians determine when to discontinue?

Answer 6

CRRT is used until patients start to show signs of kidney recovery or until they have stable blood pressure to tolerate regular dialysis. Kidney recovery is when patients start to make urine with a goal of making 500-1,000 mL/day before urine gets tested for toxins. Once kidneys are deemed capable of filtering out waste products (based on urine testing), CRRT can be discontinued.

Question 7

Why is creatinine not a good measure of kidney recovery in patients on CRRT?

Answer 7

Cr is toxin that is filtered out and like other toxins, gets cleared out by CRRT. Therefore, Cr is usually normal or low in patients on CRRT.

Question 8

What solution is used in CRRT to prevent blood from clotting?

Answer 8

Prismocitrate 18, a citrate solution used to prevent blood from coagulating (developed by Dr. Ashita Tolwani)