Fig. 1.

Summary of underlying mechanisms that contribute to HIRRT. Mechanisms include: (1) hypovolemia, (2) systolic/diastolic dysfunction, and (3) decreased vascular tone from distributive shock. They can be due to patient- or RRT-related factors or both. There is often an overlap of these mechanisms. HIRRT is associated with increased mortality. HIRRT (i.e., recurrent hypotension) may impair renal recovery, a phenomenon that may be exacerbated by impaired kidney blood flow autoregulation in AKI