Prolonged Intermittent Renal Replacement Therapy.
Prolonged intermittent renal replacement therapy (PIRRT) is becoming an increasingly popular alternative to continuous renal replacement therapy in critically ill patients with acute kidney injury. There are significant practice variations in the provision of PIRRT across institutions, with respect to prescription, technology, and delivery of therapy. Clinical trials have generally demonstrated that PIRRT is non-inferior to continuous renal replacement therapy regarding patient outcomes. PIRRT offers cost-effective renal replacement therapy along with other advantages such as early patient mobilization and decreased nursing time. However, due to lack of standardization of the procedure, PIRRT still poses significant challenges, especially pertaining to appropriate drug dosing. Future guidelines and clinical trials should work toward developing consensus definitions for PIRRT and ensure optimal delivery of therapy.
Department of Medicine, Division of Nephrology, Washington University in St. Louis, St. Louis, MO.
Fahad
F
Edrees
Department of Medicine, Division of Nephrology, Washington University in St. Louis, St. Louis, MO.
Tingting
T
Li
Department of Medicine, Division of Nephrology, Washington University in St. Louis, St. Louis, MO. Electronic address: avijayan@dom.wustl.edu.
Anitha
A
Vijayan
D058186:Acute Kidney Injury / Q000191:economics / Q000628:therapy*; D003362:Cost-Benefit Analysis; D003422:Critical Care; D016638:Critical Illness; D006801:Humans; D006435:Renal Dialysis / Q000379:methods*; D017582:Renal Replacement Therapy / Q000191:economics / Q000379:methods; D013997:Time Factors
Acute kidney injury; Extended daily dialysis; Intensive care unit; Prolonged intermittent renal replacement therapy; Sustained low-efficiency dialysis