| [ Summary ] |
If the patient with acute renal failure is hemodynamically stable, hemodialysis should be performed. If the patient is hemodynamically unstable, continuous renal replacement therapy (CRRT) should be performed. CRRT should be performed where one-to-one nursing is available. If the patient is hemodynamically unstable, requires modest clearance, and does not require large volume of ultrafiltration, peritoneal dialysis may be performed. It has been suggested that patient outcome can be improved to maintain BUN under 80 to 100 mg/dl. Recent studies have not been able to document significant benefit of more intensive dialysis. With CRRT, such as continuous hemofiltration, the aim is a clearance above 10% of the normal glomerular filtration rate. If the patient is hypercatabolic and solute removal is important, continuous hemodiafiltration is preferable. |