Continuous renal prosthetic therapy in acute renal failure: an overview

The technology surrounding the treatment of acute renal failure has been traditionally left in the realm of dialysis. The use of peritoneal dialysis for the neonate or small infant and the often difficult use of hemodialysis in larger children and adolescents have been the mainstay of support. Not infrequently, however, the multisystem nature of the failure demonstrated by these patients made either form of therapy at best inadequate. The morbidity of the procedure would add to the already high morbidity of the disease and the patient would either be unable to receive the needed medications because of necessary fluid restrictions, or be subjected to severe hemodynamic or respiratory embarrassment due to the treatment methods themselves. It is precisely toward this patient population that the continuous forms of renal replacement therapy, reviewed herein, are directed.