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Machines for Continuous Renal Replacement Therapy 

Machines for Continuous Renal Replacement Therapy
Chapter:
Machines for Continuous Renal Replacement Therapy
Author(s):

Claudio Ronco

DOI:
10.1093/med/9780190225537.003.0030
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date: 20 October 2020

Since the introduction of continuous arteriovenous hemofiltration by Kramer in 1977, continuous renal replacement therapy (CRRT) has represented an important alternative to intermittent hemodialysis or peritoneal dialysis especially in those patients where severe clinical conditions precluded the traditional forms of renal support. Arteriovenous hemofiltration enabled small centers not equipped with hemodialysis facilities to perform acute renal replacement therapy. The technique however rapidly displayed its limitations and despite good fluid control, urea clearance could not exceed 15 liters /24h. Since most critically ill patients are severely catabolic, the amount of urea removed frequently resulted in an insufficient control of blood urea levels and inadequate blood purification. For this reason, advances in CRRT have progressed over the ensuing years and now modern machines are able to provide a full range of therapies.

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