Renal replacement therapy for the critically ill--precarious progress. Part I. Definitions and physiological aspects.
Renal replacement therapy has evolved significantly in the last 15 years. Evolution has produced diversity in both techniques and terminology, leading to considerable ambiguity and confusion. Theoretical advantages of the continuous over intermittent techniques in critically ill patients exist. These include haemodynamic stability, expedient correction of metabolic derangement, accurate fluid control, cytokine clearance, and improved respiratory function. Limited clinical evidence supports this, but a clear reduction in mortality or morbidity has yet to be shown. In Part I of this review the terms and techniques used are defined and the physiological aspects of renal replacement therapy are discussed. In Part II the technical aspects will be discussed and a prescription for an effective technique in critically ill patients will be provided.
Freebairn
R C
RC
Lipman
J
J
D016638:Critical Illness; D006801:Humans; D007676:Kidney Failure, Chronic / Q000503:physiopathology / Q000628:therapy*; D017582:Renal Replacement Therapy / Q000379:methods*