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THE CLINICAL APPLICATION OF CRRT—CURRENT STATUS: Selection of Dialysate and Replacement Fluids and Management of Electrolyte and Acid-Base Disturbances


Address correspondence to: Michael A. Kraus, MD, 550 N University Blvd–UH1115, Indianapolis, IN 46202, or e-mail:


Often, too little consideration is given to the fluids used in all forms of continuous renal replacement therapy (CRRT). However, errors in fluid prescription, delivery, or creation can be rapidly fatal; in addition, fluid associated expenses can be the overriding cost in continuous renal replacement therapies. While a standard solution is frequently acceptable in most clinical circumstances, specific electrolyte and acid-base disturbances may direct changes in fluid delivery and composition. Decisions regarding fluids, whether dialysate versus replacement, including generation and composition of therapy are discussed in this review.