Do you recommend any CRRT prescription changes for optimal clearance for patients with AKI who are on a reduced blood flow rate due to concurrent regional citrate anticoagulation?
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Do you recommend any CRRT prescription changes for optimal clearance in patients with AKI who are on a reduced blood flow rate due to concurrent regional citrate anticoagulation?
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2 Answers
Mednet MemberInvited Expert
Nephrology · The University of Texas Health Science Center at San Antonio
Answered on
In distinction to conventional HD, solute clearance in CRRT is limited by dialysate/replacement solution flow, not blood flow. So, no, I do not make changes in the CRRT just because of a decrease in blood flow rate.
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Nephrology · University Of California San Francisco Medical Center At Parnassus
Answered on
At our hospital we only do CVVH, so blood flow rate does not affect clearance. If we were doing CVVHD, I would base my decision of how much clearance to provide on serum electrolytes and serum phosphorus concentration. In case of hyperkalemia, there are 2 options, increase dose of dialysis or lower ...
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