How does the modality effect solute clearance?

Small Molecules Middle Molecules Protein-Bound Molecules Size <500 Da 500 - 60,000 Da Albumin is 66 kDa (Not a middle molecule!) Variable Examples UreaCreatininePotassiumOxalateUric acid InterleukinsCytokinesB2 -microglobulinANPTNFLight chains HomocysteineHippuric...

What are the advantages and disadvantages of different modalities?

Intermittent Haemodialysis Continuous RRT Peritoneal Dialysis Advantages Efficient and intensive techniqueAllows for down-time for interventionsCan be performed overnightStaff required for a shorter timeLower costs Provides better haemodynamic stabilityEfficient...

Which factors influence the choice of modality that should be used?

Solutes to be Removed from the Plasma Patient`s Cardiovascular and Neurological Status Availability of Resources Clinician`s Experience Other Specific Clinical Considerations Hemofiltration is better at removing middle moleculesHemodialysis better at removing small...

Which modality is better for critically unwell patients?

There is no evidence that the use of either continuous or intermittent therapies have a survival benefit in critical illness Continuous modalities have been Several benefits have been proposed from the use of continuous modalities: Improved haemodynamic stability and...

What type of catheters should be used for RRT?

Catheters should be: Large diameter catheter (>11FG) – allowing blood flow in excess of 250 ml/min Polyurethane material Coaxial or lumen-in-lumen Uncuffed, non-tunnelled KDIGO...