Abstract
Dialysis means ‘to pass across’, and the mechanisms involved in renal replacement therapies include both solute and water transport across semipermeable membranes through two different, but intimately linked, mechanisms: convection and diffusion. Although in some parts of the world acute peritoneal dialysis may be used to treat acute kidney injury, nowadays this is rarely employed. Haemodialysis is viewed as a diffusive process where blood is passed over one side of a semipermeable membrane whilst on the other side, passing in the opposite direction, is an electrolyte solution. This contraflow system ensures a concentration gradient along the entirety of the membrane. Plasma water and electrolytes pass across the membrane into the electrolyte or dialysate compartment and then discarded. Haemofiltration is predominantly a convective process where plasma water and solutes are filtered across a membrane driven by hydrostatic pressure. Molecular separation is governed by the properties of the membrane.
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EF Leonard. The bases of mass seperation processes. In: Ronco C, Bellomo R, Kellum JA, editor. Critical care nephrology. Philadelphia: Saunders Elsevier; 2009. p. 1131–5.
Bird RB, Stewart WE, Lightfoot EN. Transport phenomena. New York: J Wiley; 2002.
Lightfoot EN. Transport phenomena and living systems: biomedical aspects of momentum and mass transport. New York: Wiley; 1974.
Ricci Z, Bellomo R, Ronco C. Renal replacement techniques: descriptions, mechanisms, choices and controversies. In: Bellomo R, Ronco C, Kellum JA, editors. Critical care nephrology. Philadelphia: Saunders Elsevier; 2009. p. 1136–41.
Kellum JA, Mehta RL, Angus DC, Palevsky P, Ronco C, ADQI Workgroup. The first international consensus conference on continuous renal replacement therapy. Kidney Int. 2002;62(5):1855–63.
Group, K.D.I.G.O.K.A.K.I.W. KDIGO clinical practice guideline for acute kidney injury. Kidney Int. 2012;2((S 1)):1–138.
Bunchman TE, et al. Prevention of dialysis disequilibrium by use of CVVH. Int J Artif Organs. 2007;30(5):441–4.
Ronco C, Bellomo R, Brendolan A, Pinna V, La Greca G. Brain density changes during renal replacement in critically ill patients with acute renal failure: continuous hemofiltration versus intermittent hemodialysis. J Nephrol. 1999;12(3):173–8.
Patel N, Dalal P, Panesar M. Dialysis disequilibrium syndrome: a narrative review. Semin Dial. 2008;21(5):493–8.
Schortgen F, Soubrier N, Delclaux C, Thuong M, Girou E, Brun-Buisson C, Lemaire F, Brochard L. Hemodynamic tolerance of intermittent hemodialysis in critically ill patients usefulness of practice guidelines. Am J Respir Crit Care Med. 2000;162:197–202.
Fieghen H, Wald R, Jaber BL. Renal replacement therapy for acute kidney injury. Nephron Clin Pract. 2009;112(4):c222–9.
Bagshaw SM, et al. Continuous versus intermittent renal replacement therapy for critically ill patients with acute kidney injury: a meta-analysis. Crit Care Med. 2008;36(2):610–7.
Schneider AG, et al. Choice of renal replacement therapy modality and dialysis dependence after acute kidney injury: a systematic review and meta-analysis. Intensive Care Med. 2013;39(6):987–97.
Forni LG, Hilton PJ. Continuous hemofiltration in the treatment of acute renal failure. N Engl J Med. 1997;336:1303–9.
Uchino S, Kellum JA, Bellomo R, Doig GS, Morimatsu H, Morgera S, Schetz M, Tan I, Bouman C, Macedo E, Gibney N, Tolwani A, Ronco C for the Beginning and Ending Supportive Therapy for the Kidney (BEST Kidney) Investigators. Acute renal failure in critically ill patients a multinational, multicenter study. JAMA. 2005;294(7):813–8.
Mehta RL, McDonald B, Gabbai FB, Pahl M, Pascual MT, Farkas A, Kaplan RM, Collaborative Group for Treatment of ARF in the ICU. A randomized clinical trial of continuous versus intermittent dialysis for acute renal failure. Kidney Int. 2001;60(3):1154–63.
Vinsonneau C, Camus C, Combes A, de Beauregard MA C, Klouche K, Boulain T, Pallot JL, Chiche JD, Taupin P, Landais P, Dhainaut JF, Hemodiafe Study Group. Continuous venovenous haemodiafiltration versus intermittent haemodialysis for acute renal failure in patients with multiple-organ dysfunction syndrome- a multicentre randomised trial. Lancet. 2006;368:379–85.
Ronco C, Bellomo R. Dialysis in intensive care unit patients with acute kidney injury: continuous therapy is superior. Clin J Am Soc Nephrol. 2007;2(3):597–600.
Kielstein JT, Kretschmer U, Ernst T, Hafer C, Bahr MJ, Haller H, Fliser D. Efficacy and cardiovascular tolerability of extended dialysis in critically ill patients: a randomized controlled study. Am J Kidney Dis. 2004;43(2):342–9.
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Joannidis, M., Forni, L.G. (2015). Type of Renal Replacement Therapy. In: Oudemans-van Straaten, H., Forni, L., Groeneveld, A., Bagshaw, S., Joannidis, M. (eds) Acute Nephrology for the Critical Care Physician. Springer, Cham. https://doi.org/10.1007/978-3-319-17389-4_14
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DOI: https://doi.org/10.1007/978-3-319-17389-4_14
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