Understanding Continuous Renal Replacement Therapy (CRRT)

Why is CRRT done?

CRRT is done when a person's kidneys stop working and they are too medically unstable to withstand hemodialysis because of all the blood pressure and fluid shifts. They do better with slower nonstop filtering of their blood for a long period of time, such as 24 hours or more. It’s most often given to very sick people in the hospital who:

• Have a kidney injury or kidney failure

• Have poor blood flow

• Need a lot of fluids and medicines, such as antibiotics, given through an IV

What happens before CRRT?

If you or a loved one needs CRRT, a healthcare provider will tell you what to expect. Talk with the healthcare provider if you have any questions or concerns.

What happens during CRRT?

CRRT is done only in a hospital. For this treatment:

• A healthcare provider puts a special tube (catheter) into a large blood vessel, usually in the side of the neck or groin.

• The tube is connected to a machine that holds a filter called a dialyzer.

• The machine is turned on. The tube helps carry blood to the machine. As the blood flows through the dialyzer, waste is removed and fluid and chemicals are balanced.

• The blood is then returned to the body through the tube.

• The CRRT machine may alarm for several reasons. Often, the alarm is alerting the care team that it is time to change solution bags. An alarm may sound to alert the team that a position change is needed so that the machine works properly.

During CRRT, a healthcare provider may give medicines to prevent blood clots from forming. They may also give other medicines and nutrition through an IV.

CRRT is done until the kidneys start to work again. It may be needed for several days.

What happens after CRRT?

Once CRRT is stopped, you may need another type of dialysis. Talk with a provider if you have any questions or concerns.

Risks of CRRT

All procedures have risks. CRRT has these risks:

• Heavy bleeding, infection, or blood clots forming in a blood vessel

• Electrolyte problems

• Drop in body temperature

• Low blood pressure

• Blood loss