SCCM Podcast SCCM Pod-495: Renal Resurgence: Exploring CRRT’s Impact on Critical Illness and AKI
Oct 12, 2023
Javier Neyra, MD, MSCS, a critical care nephrologist and Associate Professor at UAB, dives into the complexities of renal replacement therapy for acute kidney injury. He highlights the staggering incidence of AKI and the critical need for early intervention. Neyra contrasts CRRT with traditional hemodialysis, emphasizing the benefits of continuous therapy for hemodynamically unstable patients. He also discusses logistical challenges in implementing CRRT programs and the necessity for coordinated care between intensivists and nephrologists.
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AKI Is Extremely Common And Serious
- Acute kidney injury (AKI) affects up to half of ICU patients and correlates with multiorgan dysfunction.
- Early identification and intervention aim to promote kidney and other organ recovery.
Define Goals Before Starting RRT
- Use RRT to meet clear solute or fluid-management goals in critically ill patients.
- Let those goals guide timing and modality choice for initiation of therapy.
Match Modality To Hemodynamic Status
- Prefer CRRT when patients are hemodynamically unstable and need gradual support.
- Choose intermittent hemodialysis for stable patients or when rapid solute clearance is required.