- Guidance suggests RRT can be stopped when it is no longer required due to:
- Intrinsic recovery of kidney function
- Treatment no longer consistent with goals of care (withdrawal)
- However, determining when intrinsic function is adequate is difficult and no clear consensus exists
- The patient should be on a globally improving trend
- Several markers have been suggested for demonstrating renal recovery
- Urine volume whilst on RRT:
- A urine output >400ml in 24 hours gives an 80% chance of success at liberating from RRT
- Diuretics should not be used to enhance urine output
- Creatinine clearance whilst on RRT:
- Solute clearance stabilises after 48 hours on RRT allowing reliable measurement of creatinine clearance
- CrCl of >20ml/min should to be predictive of successful liberation
- Rarely used as a marker in clinical practice
- Urine volume whilst on RRT:
- An alternative strategy is to take a ‘filter holiday’ and monitor trends in function