Renal replacement therapy

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In medicine, renal replacement therapy is "procedures which temporarily or permanently remedy insufficient cleansing of body fluids by the kidneys."[1]

Renal replacement therapy may be used as treatment for acute kidney injury[2] or chronic kidney disease.

Classification

Methods of renal replacement therapy can be divided into temporary and permanent methods.

Temporary

  Method of solute transport Purpose Principle adverse effects
Hemodialysis Dialysis
(selective diffusion to "separate low-molecular-weight solutes which diffuse through the membrane from the colloidal and high-molecular-weight solutes which do not"[3])
For smaller molecular weight solutes (< 5000 Daltons) such as urea and creatinine Hemodynamic instability
Hemofiltration Ultrafiltration
(convective transport to "separation of particles from a suspension by passage through a filter with very fine pores"[4])
Hemodiafiltration Dialysis and ultrafiltration

Temporary methods can be divided into those that are based on convective transport of solutes and those that are based on selective diffusion of solutes.

Permanent

References

  1. Anonymous (2023), Renal replacement therapy (English). Medical Subject Headings. U.S. National Library of Medicine.
  2. VA/NIH Acute Renal Failure Trial Network, Palevsky PM, Zhang JH, O'Connor TZ, Chertow GM, Crowley ST, Choudhury D, Finkel K, Kellum JA, Paganini E, Schein RM, Smith MW, Swanson KM, Thompson BT, Vijayan A, Watnick S, Star RA, Peduzzi P. Intensity of renal support in critically ill patients with acute kidney injury. N Engl J Med. 2008 Jul 3;359(1):7-20. Epub 2008 May 20. PMID 18492867
  3. Anonymous (2023), Dialysis (English). Medical Subject Headings. U.S. National Library of Medicine.
  4. Anonymous (2023), Ultrafiltration (English). Medical Subject Headings. U.S. National Library of Medicine.