renal replacement therapy

Introduction

Term used for treatment of end-stage renal disease. Treatment modalities would include:

• renal dialysis
  • hemodialysis*
    • continuous renal replacement therapy (CRRT)
  • peritoneal dialysis*
• renal transplantation
• investigational wearable artificial kidney

* clinical outcomes are the same for peritoneal dialysis vs hemodialysis

Indications

• end-stage renal disease
• early renal replacement therapy of no benefit for patients with septic shock, acute respiratory distress syndrome or other critical illness
• oliguria or anuria for > 72 hours or elevated blood urea nitrogen (BUN; > 112mg/dL)

Management

• patient education prior to end-stage renal disease increases likelihood of
  • listing for renal transplant
  • preemptive renal transplantation
    • superior quality of life, improved survival, less expensive than long-term renal dialysis
  • selection of home modality (peritoneal dialysis)
  • mortality benefit

More general terms

• clinical procedure

More specific terms

• continuous renal replacement therapy (CRRT)
• renal dialysis
• renal transplantation

Additional terms

• end-stage renal disease (ESRD)