January - March 2021

Renal Replacement Therapies in Kidney Disease

Sanjiv Mahajan*

Chief Medical Officer, Department of Nephrology & Medicine, Safdarjung Hospital & Vardhman Mahavir Medical College, New Delhi, India


Renal replacement therapy (RRT) artificially replaces function of the kidney when it is damaged. Plethora of modalities has developed, each having its unique indication and advantages. The first step in choosing RRT is to establish whether damage is acute or chronic. There are specific indications in starting RRT in each. Hemodialysis and hemofiltration utilizes external “filters” while in peritoneal dialysis, peritoneal membrane of the patient is used for the purpose. Slow continuous therapies such as ‘sustained low-efficiency dialysis’ and ‘continuous renal replacement therapy’ have developed as variant of hemodialysis and hemofiltration making it possible to dialyze hemodynamically unstable patients. Except the transport characteristics of the peritoneum all other variables in RRT can be adjusted to achieve the desired response. Understanding of the underlying principles of each modality helps in choosing a right RRT for the patient. Various types of dialysis have been discussed in detail in the article.
Key words: renal replacement therapy, hemodialysis, hemofiltration, peritoneal dialysis, sustained low-efficiency dialysis, continuous renal replacement therapy.

Keywords: Renal Replacement Therapies in Kidney Disease

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