Renal replacement therapy (RRT) involves the use of semipermeable membranes to remove fluid and toxic substances from the bloodstream
The basic methods of RRT are hemodialysis (HD) and hemofiltration (HF)
There have been a few cases in our ED in which our Renal consultants have used HF
Hemofiltration can remove large volumes of fluid (up to 3 Liters per hour)
Major advantages to HF: less likely to produce hypotension than HD, can remove larger molecules than HD
Disadvantages to HF: must be done continuously to provide effective dialysis, requires anticoagulation to maintain circuit patency, not well suited for hypotensive patients (requires a hydrostatic pressure gradient for solute clearance)