Selection of dialysate and replacement fluids and management of electrolyte and Acid-base disturbances.
Often, too little consideration is given to the fluids used in all forms of continuous renal replacement therapy (CRRT). However, errors in fluid prescription, delivery, or creation can be rapidly fatal; in addition, fluid associated expenses can be the overriding cost in continuous renal replacement therapies. While a standard solution is frequently acceptable in most clinical circumstances, specific electrolyte and acid-base disturbances may direct changes in fluid delivery and composition. Decisions regarding fluids, whether dialysate versus replacement, including generation and composition of therapy are discussed in this review.
Department of Medicine, Division of Nephrology, Indiana University Medical School and Clarian Health, Indianapolis, IN 46202, USA. mkraus@iupui.edu
Michael A
MA
Kraus
D000137:Acid-Base Imbalance / Q000209:etiology / Q000517:prevention & control*; D015314:Dialysis Solutions / Q000737:chemistry* / Q000627:therapeutic use; D004573:Electrolytes / Q000032:analysis* / Q000627:therapeutic use; D006801:Humans; D008274:Magnesium / Q000032:analysis; D010758:Phosphorus / Q000032:analysis; D011188:Potassium / Q000032:analysis; D051437:Renal Insufficiency / Q000628:therapy; D017582:Renal Replacement Therapy / Q000009:adverse effects / Q000379:methods*; D012964:Sodium / Q000032:analysis; D014883:Water-Electrolyte Imbalance / Q000209:etiology / Q000517:prevention & control*
D015314:Dialysis Solutions; D004573:Electrolytes; D010758:Phosphorus; D012964:Sodium; D008274:Magnesium; D011188:Potassium