Continuous Renal Replacement Therapy in Critically Patients: benefits, challenges, and perspectives in the management of acute kidney injury

Abstract

Acute kidney injury (AKI) is a common complication in critically ill patients admitted to Intensive Care Units (ICUs), often associated with high morbidity and mortality rates. Continuous Renal Replacement Therapy (CRRT) stands out as an effective alternative for managing these patients, particularly in the presence of hemodynamic instability. This literature review analyzed the available evidence on CRRT use in ICUs, addressing its principles, benefits, challenges, and limitations. CRRT offers advantages such as gradual solute and fluid removal, cardiovascular stability, and potential inflammatory modulation in critical conditions like sepsis and multiple organ dysfunction syndrome. However, challenges such as high costs, the need for anticoagulation, and specific infrastructure were highlighted. Although CRRT is widely recommended for critically ill patients, the literature reveals gaps in protocol standardization and the assessment of long-term outcomes, such as renal recovery and mortality reduction. The study concludes that CRRT should be used judiciously, considering the patient’s clinical conditions and available resources. Additionally, the need for further research is emphasized to optimize clinical practice and expand access to therapy. This work contributes to understanding the importance of CRRT in managing AKI in ICUs and developing more effective and accessible strategies.