Management and complications of patients on renal replacement therapy on AMU

Abstract

Renal replacement therapy (RRT) describes treatments used to replace the function of the kidneys and includes haemofiltration, dialysis and kidney transplantation. Haemofiltration and its variants are used acutely, primarily in intensive care settings. Haemodialysis and peritoneal dialysis are longer term treatments used either as a bridge to renal transplantation or more permanently for individuals not suitable for a transplant. Transplantation is the only type of RRT that replaces all functions of the kidneys, including endocrine functions such as erythropoietin production and vitamin D activation. No form of RRT is without complication, and managing these patients requires specialist input. However, many clinicians, especially on acute medical units, can find themselves managing these patients acutely; therefore, what follows is key information on initial management.