ABSTRACT
Acute kidney injury remains a common and morbid complication affecting 57% of critically ill patients, 23.5% of whom will require renal replacement therapy. Intermittent hemodialysis (IHD) is widely available and is most commonly performed by dedicated dialysis nurses. There are several different types of continuous renal replacement therapy (CRRT) available which can use dialysate to achieve diffusive clearance as with continuous venovenous hemodialysis, or replacement fluid can be utilized for convective clearance with continuous venovenous hemofiltration. CRRT addresses many of these clinical concerns by performing both solute clearance and ultrafiltration at a slower rate. The main take away point from the Hemodiafe trial, and the other mentioned trials comparing CRRT to IHD, should be that IHD remains a reasonable option for most critically ill patients in the intensive care unit. Cardiac dysfunction is a common comorbidity in patients requiring IHD and blunts the physiologic responses to the hemodynamic stressors.
