Online monitoring in continuous renal replacement therapies.

Technical improvements in dialysis equipment for chronic hemodialysis patients has mirrored improvements in continuous renal replacement therapies (CRRTs) for patients with acute renal failure who are critically ill. This article reviews the available types and importance of online monitors such as urea sensors to provide real-time urea kinetic parameters, temperature sensors to target thermal balance throughout each session, conductivity measurement of sodium balance in the dialysate, blood volume monitoring to aid against cardiovascular instability and treatment-induced hypotension, biofeedback systems, and remote dialysis/teledialysis for efficient use of trained personnel.

[1]  J. Daugirdas Rapid methods of estimating Kt/V: three formulas compared. , 1990, ASAIO transactions.

[2]  M. F. Schultz,et al.  Responses to hemorrhagic arterial pressure reduction in different ischemic renal failure models. , 1994, Kidney international.

[3]  W. McCready,et al.  Urea kinetic modeling with a prototype urea sensor in the spent dialysate stream. , 1993, ASAIO journal.

[4]  C. Ronco,et al.  Continuous renal replacement therapies in the treatment of acute renal failure in intensive care patients. II: Clinical indications and prescription , 1994 .

[5]  Rinaldo Bellomo,et al.  Critical Care Nephrology , 1998, Springer Netherlands.

[6]  R. Longnecker,et al.  Continuous arteriovenous hemofiltration. A report of six months' experience. , 1984, Annals of internal medicine.

[7]  C. Ronco,et al.  Continuous Arteriovenous Hemofiltration in the Critically Ill Patient: Clinical Use and Operational Characteristics , 1983 .

[8]  C. Ronco,et al.  Solute and Water Transport during Continuous Arteriovenous Hemofiltration (CAVH) , 1987, The International journal of artificial organs.

[9]  T. Depner Prescribing Hemodialysis: A Guide to Urea Modeling , 1990 .

[10]  C. Ronco Continuous renal replacement therapies for the treatment of acute renal failure in intensive care patients. , 1993, Clinical nephrology.

[11]  P. Ghezzi,et al.  Theoretical model and first clinical results of the paired filtration-dialysis (PFD). , 1983, Life support systems : the journal of the European Society for Artificial Organs.

[12]  R. Bellomo,et al.  Today's technology for continuous renal replacement therapies , 1996 .

[13]  R. Bellomo,et al.  Continuous versus intermittent renal replacement therapy in the treatment of acute renal failure. , 1998, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[14]  R. Bellomo,et al.  Future technology for continuous renal replacement therapies , 1996 .

[15]  D. Matthaei,et al.  Arteriovenous haemofiltration: A new and simple method for treatment of over-hydrated patients resistant to diuretics , 1977, Klinische Wochenschrift.

[16]  W. Silvester Outcome studies of continuous renal replacement therapy in the intensive care unit. , 1998, Kidney international. Supplement.

[17]  K. Jindal,et al.  Percent reduction in blood urea concentration during hemodialysis (PRU). A simple and accurate method to estimate Kt/V urea. , 1987, ASAIO transactions.

[18]  R. Bellomo,et al.  Nomenclature for continuous renal replacement therapies , 1996 .

[19]  P Zucchelli,et al.  Blood volume regulation during hemodialysis. , 1998, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[20]  J. Daugirdas,et al.  Cardiopulmonary recirculation in dialysis. An underrecognized phenomenon. , 1992, ASAIO journal.

[21]  R. Bellomo,et al.  Complications with continuous renal replacement therapy , 1996 .

[22]  A Santoro,et al.  On-line monitoring. , 1995, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[23]  C. Ronco,et al.  On-Line Urea Monitoring: A Further Step towards Adequate Dialysis Prescription and Delivery , 1995, The International journal of artificial organs.

[24]  C. Ronco Continuous renal replacement therapies in the treatment of acute renal failure in intensive care patients. Part 1. Theoretical aspects and techniques. , 1994, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[25]  B. J. van der Meer,et al.  Combined Measurement of Tissue Fluid, Blood Volume and Hemodynamics in Hemodialysis , 1995, The International journal of artificial organs.

[26]  H Håkanson,et al.  Continuous monitoring of urea in blood during dialysis. , 1991, Biosensors & bioelectronics.

[27]  R. Bellomo,et al.  Adequacy of Renal Replacement Therapy , 1995 .

[28]  L. Pedrini,et al.  Causes, kinetics and clinical implications of post-hemodialysis urea rebound. , 1988, Kidney international.

[29]  T. Depner,et al.  Assessing adequacy of hemodialysis: urea modeling. , 1994, Kidney international.

[30]  K Thomaseth,et al.  PANSYM: a symbolic equation generator for mathematical modelling, analysis and control of metabolic and pharmacokinetic systems. , 1994, Computer methods and programs in biomedicine.

[31]  R. Bellomo,et al.  Nephrology Dialysis Transplantation Acute renal failure in the intensive care unit : adequacy of dialysis and the case for continuous therapies , 2005 .

[32]  J. Burema,et al.  Effect of dialysate temperature on energy balance during hemodialysis: quantification of extracorporeal energy transfer. , 1999, American journal of kidney diseases : the official journal of the National Kidney Foundation.