Dialysis modalities in the intensive care unit

During the past decade, a number of advances have been made in the field of renal replacement therapy. Clinicians have gained a better appreciation of the need for early and aggressive management of patients with renal failure in the intensive care unit (ICU) [12]. Although a number of treatment modalities exist, there seems to be continued controversy about selection of the most appropriate modality for each individual patient. This article discusses the clinical spectrum of renal failure in the ICU, indications for the initiation of dialysis, principles of dialysis therapy, and unique features, advantages, disadvantages, and usefulness of the various renal replacement modalities available.