Renal Replacement Therapy (RRT) is a treatment option for patients with severe chronic kidney disease (CKD) or acute kidney injury (AKI) when the kidneys can no longer adequately filter blood. RRT helps to remove waste products, balance fluids and electrolytes, and perform other kidney functions. The main types of RRT include:

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1. Hemodialysis

 

Description: Hemodialysis involves filtering the blood through a machine. A dialysis machine and a special filter called a dialyzer or artificial kidney are used to clean the blood.

 

Process: Blood is drawn from the patient’s body, passed through the dialyzer to remove waste and excess fluids, and then returned to the body. This process usually takes about 3-4 hours and is typically done three times a week.

 

Setting: Can be performed in a dialysis center or at home (home hemodialysis), with the latter offering more flexibility.

 

 

 

2. Peritoneal Dialysis

 

​Description: In peritoneal dialysis, the lining of the patient’s abdomen (peritoneum) acts as a natural filter

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Process: A cleansing fluid called dialysate is introduced into the abdominal cavity through a catheter. Waste products and excess fluids are drawn into the dialysate, which is then drained away and replaced with fresh solution. There are two main types:

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Continuous Ambulatory Peritoneal Dialysis (CAPD): The patient performs the dialysis manually, typically 4-5 times a day.

 

Automated Peritoneal Dialysis (APD): A machine performs the exchanges overnight while the patient sleeps.

 

Setting: Peritoneal dialysis can be done at home, providing greater flexibility and independence.

 

 

 

3. Kidney Transplant​

 

Description: A kidney transplant involves surgically placing a healthy kidney from a donor into a patient whose kidneys are no longer functioning properly.

 

Process: The new kidney takes over the work of the failed kidneys. The donor kidney can come from a living donor or a deceased donor.

 

Considerations: Requires lifelong use of immunosuppressive drugs to prevent the body from rejecting the transplanted kidney. It is considered the most effective form of RRT in terms of improving quality of life and long-term survival.

 

 

 

4. Continuous Renal Replacement Therapy (CRRT)

 

Description: CRRT is typically used in critically ill patients, often in an intensive care unit (ICU) setting.

 

Process: It involves slower, continuous dialysis to remove waste and fluid, and is gentler than traditional dialysis methods. This is particularly useful for patients with unstable blood pressure or heart conditions.

 

 

 

5. Conservative Management

 

Description: For some patients, especially those with multiple serious health issues or elderly individuals, aggressive treatment like dialysis or transplant may not be the best option.

 

Process: This approach focuses on managing symptoms and maintaining the best possible quality of life without dialysis or transplant.

 

Choosing the appropriate RRT option depends on the patient's overall health, lifestyle preferences, and the availability of treatment options.