Pre- vs. Post-dilution in CRRT

In this brief 5-minute video, Dr. Bill Clark discusses the advantages and disadvantages of pre- or post-dilution alone, and benefits of using a device that allows simultaneous use of both. As Dr. Clark explains, a combination of both approaches can be a desirable method for optimizing CRRT solute clearance.

Why are scale-based systems important in CRRT?

In this short 5-minute video, leading pediatric nephrologist Dr. Stuart Goldstein, from Cincinnati Children’s Hospital, speaks about scale-based systems. Removing the correct amount of fluid is important for children and adults alike. Learn more by watching this informative video.

Timing of Renal Support Initiation in AKI

Presented by Sean M. Bagshaw, MD, MSc, FRCPC

This webinar will discuss how the decision to initiate RRT is incredibly complex and involves many factors. The classic indications alone are not optimal for everyone. Expanded indications in critical illness might be something we need to consider, especially when looking at patients with illness severity and organ dysfunction.

This presentation will cover:

• Epidemiology
• Definition of “Timing”
• Current Practice
• Available Evidence
• Fluid Accumulation

Fluid Balance and Outcomes in AKI Patients

Presented by Dr. Ravindra L. Mehta

This 25-minute presentation, led by Dr. Ravindra Mehta, was taken from a live panel discussion hosted by Gambro at the 2009 ASN Congress in San Diego, CA. This presentation will focus on the pathophysiologic aspect of critical illness and how this can promote the development of fluid overload.

This presentation will cover:

• Pathophysiology of fluid accumulation in critically ill patients
• Influence of fluid overload on AKI patient outcomes
• Clinical management of fluid overload in AKI

Dialysis Modality Choice in AKI: Effect on Long-term Dialysis Dependence

Presented by Dr. John A. Kellum

This 25-minute presentation, presented by John A. Kellum, will focus on recent clinical research that includes a comparison between two large randomized controlled trials and a discussion on the modality choice for patients with AKI.

This presentation will cover:

• The association between CRRT and improved renal recovery after AKI within large observational studies
• A comparison of the two largest AKI dose/outcome trials (ATN and RENAL) from the specific perspective of renal recovery
• The choice of modality used for patients with AKI - choosing the right tool for the job
• A look at future needs to evaluate CRRT's benefits with respect to renal recovery

Randomized Evaluation of Normal vs. Augmented Level (RENAL) of Replacement Therapy Intensity Study

Presented by Dr. Rinaldo Bellomo

This 30-minute presentation, presented by the investigator, Dr. Rinaldo Bellomo, will focus on the RENAL study, the largest randomized control trial of its kind. The webinar contains highlights of the RENAL study, recently published in the New England Journal of Medicine.

This presentation will cover:

• 90-day mortality and renal recovery outcomes that are substantially better than what has been previously reported for this patient population
• Comparison of RENAL trial to ATN, the second largest randomized controlled trial published in the New England Journal of Medicine
• Practical applications for your CRRT program such as when to initiate therapy, importance of dose delivery, and modality selection

CRRT Dosing: New Data, New Perspectives for critically ill patients with Acute Kidney Injury

Presented by Dr. Claudio Ronco

This 30-minute presentation will focus on recent clinical research on this topic, including the RENAL study, recently published in the New England Journal of Medicine. This presentation was taped at a speaker panel session, at ASN in San Diego in 2009.

This presentation will cover:

• The implications of dialysis modality choice (CRRT vs. IHD) in the management of AKI patients
• Recent trial data that suggests prescribing higher dose does not positively affect patient outcomes
• The prescribed CRRT dose does not equate to the delivered dose. Overshooting may be required to get the minimum dose