Visual summary
Reassess kidney recovery, changing stability, and readiness for another modality or discontinuation. Continuous therapy should have an active daily purpose.
Text version
Continuous support
Continuous kidney replacement offers gradual solute and fluid management, often useful in unstable patients. Clearance depends on the selected modality and delivered effluent.
Clarify the indication
Assess electrolyte emergencies, acidemia, fluid overload, uremia, and ongoing metabolic demand. Hemodynamic instability informs modality but does not define the entire prescription.
Account for the circuit
Vascular access, filter function, anticoagulation, prefilter dilution, and downtime all influence delivery. The machine setting alone is not the actual dose.
Titrate net fluid removal
Separate clearance goals from the patient's net fluid balance. Adapt removal to perfusion, vasopressors, capillary refill, congestion, and the evolving illness.
Monitor treatment losses
Follow electrolytes, phosphate, temperature, nutrition, and drug clearance. Citrate protocols require appropriate acid–base and calcium monitoring.
Plan transitions
Reassess kidney recovery, changing stability, and readiness for another modality or discontinuation. Continuous therapy should have an active daily purpose.
Continue learning
This graphic summarizes a topic. The full educational pages provide the broader discussion and references.