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Renal replacement therapy

Renal replacement therapy is a method of removing plasma waste products and excess fluid and maintaining normal electrolyte concentrations. It is used when the kidneys are unable to perform this function. It may be used temporarily in acute kidney injury or long-term in chronic kidney disease.

Indications

Acute kidney injury

Refractory – AEIOU 

  • Acidosis
  • Electrolyte abnormalities (hyperkalaemia, hyponatraemia, hypercalcaemia)
  • Intoxicants (methanol, lithium, salicylates)
  • Overload 
  • Uraemia

Chronic kidney disease

In chronic kidney disease, renal replacement therapy is generally required when the GFR is <15ml/minute, and there are symptoms or complications of kidney disease.

Types of renal replacement therapy

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Some questions for you

What is haemodiafiltration? What is the advantage of it?

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What are the complications of renal replacement therapy?

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What are the commonest reasons for end-stage chronic kidney disease?

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