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Acute hemodialysis prescription

Phillip Ramos, MD, MSCI
Thomas A Golper, MD
Section Editors
Jeffrey S Berns, MD
Paul M Palevsky, MD
Richard H Sterns, MD
Deputy Editor
Alice M Sheridan, MD


Acute kidney injury (AKI), formerly called acute renal failure (ARF), is a major cause of morbidity and mortality, particularly in the hospital setting. Despite improvements in renal replacement therapy (RRT) during the last several decades, the mortality rate associated with AKI in critically ill patients remains high. (See "Renal and patient outcomes after acute tubular necrosis".)

Acute RRT is commonly indicated for patients with AKI. Available modalities for acute RRT include peritoneal dialysis, intermittent hemodialysis and variations of intermittent hemodialysis (such as hemofiltration), and continuous renal replacement therapy (CRRT).

This topic reviews the acute hemodialysis prescription for patients with AKI. The indications for acute dialysis and the choice of dialysis modality are discussed separately. (See "Renal replacement therapy (dialysis) in acute kidney injury (acute renal failure) in adults: Indications, timing, and dialysis dose", section on 'Indications for and timing of initiation of dialysis' and "Renal replacement therapy (dialysis) in acute kidney injury (acute renal failure) in adults: Indications, timing, and dialysis dose", section on 'Optimal modality' and "Continuous renal replacement therapy in acute kidney injury (acute renal failure)" and "Use of peritoneal dialysis for the treatment of acute kidney injury (acute renal failure)".)

The optimal vascular access for hemodialysis is discussed elsewhere. (See "Overview of central catheters for acute and chronic hemodialysis access".)


The components of the acute dialysis prescription include the choice of hemodialysis membrane, dialysate composition and temperature, blood flow rate, amount and rate of ultrafiltration (UF), choice of anticoagulation, and total dialysis dose.


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Literature review current through: Sep 2015. | This topic last updated: Sep 16, 2015.
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