Continuous Renal Replacement Therapy (CRRT)

CRRT is a mode of renal replacement therapy for hemodynamically unstable, fluid overloaded patients and patients with sepsis and septic shock & in management of acute renal failure especially in the intensive care unit setting.

The popularity of ‘slow continuous therapies’ for the treatment of critically ill patients with renal failure is increasing. The techniques which are most commonly used are slow continuous hemodialysis  and hemodiafiltration. Slow continuous hemofiltration and slow continuous ultrafiltration also are commonly used. Management in initial hours to counter the derangements in critically ill patients is the most vital thing in the therapy. CRRT initiated for ARF in critically ill patients serves as a renal ‘replacement’ therapy mimicking as artificial kidney support. It will enhance recovery of the native kidneys with prevention of hyperkalemia, hyper/hyponatremia, acidosis/alkalosis and rapid correction of pulmonary/peripheral edema by gradual and consistent removal of extra fluid retained in the body.

CRRT actually describes four different therapies.

  1. SCUF: Slow Continuous Ultrafiltration
  2. CVVH: Continuous Veno-Venous Hemofiltration
  3. CVVHD: Continuous Veno-Venous Hemodialysis
  4. CVVHDF: Continuous Veno-Venous Hemodiafiltration

A separate dialysis machine is dedicated for this procedure. Patients are monitored around the clock during the procedure, which is carried out continuously for a period of 24 to 48 hours. This therapy is provided in conjunction with the Dialysis team, Intensive Care nurses and physicians.