3. Continuous Renal Replacement Therapy (CRRT) “ “ Any extracorporeal blood purification therapy intended to substitute for impaired renal function over an extended period of time and applied for or aimed at being applied for 24 hours/day.” Bellomo R., Ronco C., Mehta R, Nomenclature for Continuous Renal Replacement Therapies, AJKD, Vol 28, No. 5, Suppl 3, Nov 1996
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7. R isk I njury F ailure L oss E SRD GFR Criteria Urine Output Criteria Increased creatinine x 1.5 or GFR decrease >25% UO <,0.5ml/kg/hr x 6 hours Increased creatinine x 2 or GFR decrease >50% UO <0.5 ml/kg/hr x 12 hours Increased creatinine x 3 or GFR decrease >75% or Serum Creatinine > 4mg/dl UO <0.3 ml/kg/hr x 24 hours or anuria x 12 hours Persistent ARF= complete loss of renal function >4 weeks End-stage renal disease (>3 months) Early Initiation
8. Cumulative Survival (%) vs Treatment Dose Effects of different doses in CVVH on outcome of ARF - Ronco & Bellomo study. Lancet . july 00 100 90 80 70 60 50 40 30 20 10 0 Group 1(n=146) ( Uf = 20 ml/h/Kg) Group 2 (n=139) ( Uf = 35 ml/h/Kg) Group 3 (n=140) ( Uf = 45 ml/h/Kg) 41 % 57 % 58 % p < 0.001 p n..s. p < 0.001 Survival (%)