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. 2022 Aug 18;18(2):256–269. doi: 10.2215/CJN.04350422

Table 1.

Potential advantages and disadvantages of continuous KRT (relative to intermittent hemodialysis or prolonged intermittent KRT)

Advantages Disadvantages

  • • Less hypotension

  • • Less effect on intracranial pressure in at-risk patients (e.g., acute brain injury, acute liver failure)

  • • Superior volume control

  • • Superior solute control (i.e., higher total daily or weekly dosage)

  • • Permits nutrition without restriction in protein, phosphate, or potassium

  • • Less hemodialysis nurse supportc

  • • Decreased (i.e., slower) instantaneous clearance

  • • Increased need for circuit anticoagulation due to extended treatment time

  • • Increased risk of hypophosphatemia

  • • Requires catheter placementa

  • • Increased risk of immobilizationb

  • • More ICU nurse supportc

  • • Increased overall cost

ICU, intensive care unit; CKRT, continuous KRT.

a

Although one single-center observational study39 suggests using arteriovenous fistulae/grafts for CKRT may be safe and feasible, doing so is not standard of care in most institutions.

b

Note that CKRT is not a contraindication to early mobilization per se because observational data suggest that physical rehabilitation is feasible and safe in patients on CKRT,85 but many providers perceive CKRT to be a barrier to physical therapy.

c

Relative amounts of dialysis versus ICU nurse support will depend on local staffing models.