From: How I prescribe prolonged intermittent renal replacement therapy
Parameter | Modality | |||
---|---|---|---|---|
Standard Intermittent IHD | PIRRT | Standard CRRT | ||
Using IHD Machine | Using CRRT Machine | |||
Clearance mode | Diffusion | Diffusion or Diffusion + Convection | Diffusion or Convection or Diffusion + Convection | |
Blood flow rate | ≥ 300 mL/min | 100–300 mL/min | 100–200 mL/min | |
Duration | 3–4 h | 6–12 h | 8–12 h | Continuous |
Frequency | 3–4 days/week | 4–7 days/week | ||
Dialyzate rate | 500–800 mL/min | 100–400 mL/min | 10–30 mL/min | |
Replacement Rate* | N/A | 1–2 L/hour | 20–40 mL/min | 10–30 mL/min |
Dialyzer Surface area | 1.0–2.5 m2 | 0.6–2.5 m2 | 0.6–1.5 m2 | |
Need for Anticoagulation | + | + | + + + | |
Dialyzate [Na+] | 145 mmol/Lδ | 140 mmol/LΨ | ||
Dialyzate [K+] | 4 mmol/Lδ | |||
Dialyzate [Ca + +] | 1.5 mmol/Lδ | 1.75 mmol/L (0 mmol/L if using RCA) Ψ | ||
Dialyszte [HCO3] | 24 – 36 mmol/Lδ | 32 mmol/LΨ | ||
Options for pre-emptive PO4 supplementation once serum [PO4] ≤ 1–1.6 mmol/L | Add PO4 to dialyzate | Add PO4 to standard CRRT fluids or switch to commercially available PO4-containing fluids | ||
Oral/enteral PO4 administration |