Abstract:
Acute renal failure (ARF) is a common complication of sepsis and carries a high
mortality. Renal replacement therapy (RRT) during the acute stage is the mainstay
of therapy. Va-rious modalities of RRT are available. Continuous RRT using
convective methods are preferred in sepsis-induced ARF, especially in
hemodynamically unstable patients, although clear evidence of benefit over
intermittent hemodialysis is still not available. Peritoneal dialysis is clearly
inferior, and is not recommended. Early initiation of RRT is probably
advantageous, although the optimal timing of dialysis is yet unknown. Higher
doses of RRT are more likely to be beneficial. Use of bio-compatible membranes
and bicarbonate buffer in the dialysate are preferred. Anticoagulation during
dialysis must be carefully adjusted and monitored.
