Renal Replacement Therapy in Intensive Care Unit

*Dhaval Patel, Hussain Majeed, Megan Joseph and Gurleen Kaur*

## **Abstract**

This chapter presents a comprehensive overview of the latest advancements in renal replacement therapy (RRT) including Continuous Renal Replacement Therapy (CRRT), focusing on key topics such as acute kidney injury (AKI), renal replacement techniques, patient selection, vascular access, dialyzer membranes, anticoagulation strategies, optimal RRT prescription, drug dosing, laboratory monitoring, and complications of RRT. The incidence of AKI in intensive care unit (ICU) is estimated to be from 5% to 50%. It carries substantial morbidity and mortality. In this chapter, we aim to emphasize the significance of AKI in ICU and indications that necessitate effective RRT. The chapter explores various renal replacement techniques with emphasis on CRRT, including continuous venovenous hemodialysis, hemodiafiltration, and hemofiltration. The clinical indications and contraindications for CRRT are discussed. Vascular access options, dialyzer membrane characteristics, and anticoagulation strategies are examined, providing insights into their impact on treatment outcomes and patient safety. Additionally, highlighted points include the importance of optimal RRT prescription, drug dosing adjustments, and laboratory monitoring in CRRT. It addresses potential complications associated with CRRT and offers strategies for their prevention and management. Overall, this book chapter aims to serve as a valuable guide for healthcare professionals, providing them with updated information to optimize patient care and improve outcomes in individuals with AKI undergoing RRT in ICU.

**Keywords:** renal failure, acute kidney injury, continuous renal replacement therapy (CRRT), hemofiltration, hemodialysis, peritoneal dialysis
