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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

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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