S3 guidelines on renal replacement therapy in intensive care medicine S3-Leitlinie Nierenersatztherapie in der Intensivmedizin
Harth A, Willam C, Jörres A (2025)
Publication Type: Journal article
Publication year: 2025
Journal
DOI: 10.1007/s11560-025-00880-0
Abstract
The indications to initiate acute renal replacement therapy (ARRT) include treatment refractory disturbances of the electrolyte, acid-base or fluid status as well as severe clinical symptoms of the uremic syndrome. In most other cases a watch and wait strategy is justified, provided that a clinical re-evaluation is performed at least daily; however, if the clinical situation and trajectory of the disease suggest that ARRT will be necessary, treatment should be initiated even in the absence of urgent indications. Continuous and intermittent modalities should be used as complementary procedures. For anticoagulation a regional citrate or systemic heparin (mostly with unfractionated heparin) can be used in most cases. Guidelines recommend a total effluent volume (dialysate plus filtrate) of 20–25 ml/kg/h for continuous ARRT, which will usually require a higher prescription of effluent volume. Weaning from ARRT can be attempted in patients with stable hemodynamics, fluid, electrolyte and acid-base status who have regained a relevant urine output (> 300–600 ml/24 h).
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Germany (DE)How to cite
APA:
Harth, A., Willam, C., & Jörres, A. (2025). S3 guidelines on renal replacement therapy in intensive care medicine S3-Leitlinie Nierenersatztherapie in der Intensivmedizin. Die Nephrologie. https://doi.org/10.1007/s11560-025-00880-0
MLA:
Harth, Ana, Carsten Willam, and Achim Jörres. "S3 guidelines on renal replacement therapy in intensive care medicine S3-Leitlinie Nierenersatztherapie in der Intensivmedizin." Die Nephrologie (2025).
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