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Drug Dosing in Continuous Renal Replacement Therapy 

Drug Dosing in Continuous Renal Replacement Therapy
Drug Dosing in Continuous Renal Replacement Therapy

Adrian Wong

, Sandra L. Kane-Gill

, and John A. Kellum

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date: 31 July 2021

Acute kidney injury (AKI) in the intensive care unit (ICU) occurs in 5 to 25% of patients. Of this population, approximately 6% require renal replacement therapy (RRT). Mortality in patients requiring RRT is estimated to be even higher than in patients with AKI not requiring RRT (60%), approaching up to 80%. Modes of RRT include intermittent hemodialysis (IHD) or continuous renal replacement therapy (CRRT). CRRT offers the potential advantage of continuous removal of fluid and solutes, reducing potential fluctuations in electrolytes, fluid balance, and hemodynamic stability, compared to IHD. Although there is ongoing debate regarding the optimal use and application of RRT in the ICU, its frequent use necessitates drug dosing considerations. Along with the numerous comorbidities and physiologic factors that may affect drug dosing in critically ill patients, RRT only adds to the complicated nature of these patients.

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