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3 treatment options for patients with ESRD
HD, PD, kidney transplantations
Timing for CRRT vs HD vs PD
CRRT: 24 h
HD: 3-5h 3x/week
PD: 8-12-24 h per day
Population targeted for CRRT vs HD vs PD
CRRT: critically ill (ONLY IN ICU)
HD: mostly am care
PD: am care
Is HD, PD, or CRRT better at treating hyperkalemia?
HD
Patient mobility for CRRT vs HD vs PD
CRRT: immobile
HD: mobile when not connected
PD: mobile
CRRT benefits
better hemodynamic stability and volume control
HD benefits
higher efficiency, low technique failure rate, early detection of underdialyssis, intermittent tx/heparin,
closer pt monitoring
PD benefits
Improves CV stability due to slow UFR, preserves residual renal function (less stress on heart and
kidneys), higher clearance of larger solutes, maintains independence, less blood loss/anemia, no
heparin required, convenient route for insulin/abx
CRRT risks
Continuous nursing care, anticoagulant needed, increased cost, hypothermia
HD risks
requires multiple visits/wk, disequilibrium, increased risk of hypotension and muscle cramps, less
volume control, infections related to membranes, rapid decline of residual renal function
PD risks
protein/AA losses, abdominal fullness = malnutrition, peritonitis risk, catheter malfunction,
inadequate UF/solute clearance in larger pts, pt burnout/technique failure, obesity risk w/glucose,
mechanical problems, no convenient access for IV iron