2013 Volume 4 Issue 2 Pages 120-127
Renal replacement therapy (RRT) for critically ill patients with acute kidney injury (AKI) is provided as either intermittent renal replacement therapy (IRRT) or continuous renal replacement therapy (CRRT). Intermittent hemodialysis (IHD), which is a typical modality of IRRT, is often complicated by hypotension and inadequate fluid removal. Sustained low-efficiency dialysis (SLED) is a novel RRT appropriate for a broad range of solutes and volume removal. SLED is a slower dialytic modality run for prolonged periods (6- to 12-hour) using conventional hemodialysis machines with modification of blood and dialysate flows. SLED allows units where CRRT equipment or personnel are unavailable to offer a treatment modality that should achieve similar benefits as CRRT. Although SLED can technically be classified as a type of IRRT based on treatment duration, it combines the advantages of IRRT and CRRT and affords better hemodynamic stability, correction of hypervolemia, and solute removal. In Japan, we need to consider the definition and positioning of SLED as one of the RRT modalities.
