Steve Gets Continuous Renal Replacement Therapy in the CCU -- the Ultimate in Extended Dialysis

Steve is in the Coronary Care Unit, recovering from an Aortic Valve Replacement and a Four-Vessel Coronary Artery Bypass Graft (AVR and CABG).

I found it interesting that he has been placed on Continuous Renal Replacement Therapy (CRRT). This means he will be dialyzed twenty-four hours a day; he currently is running at a pump speed of 150 cc/ min and taking off only 100 cc per hour.

This must be the ultimate in Extended Dialysis: prescribed for patients who are medically fragile and cannot handle wide volume swings.

Nobody here seems to find this therapy "exotic." Why, then, is there a controversy regarding the benefits of  frequent slower and gentler extended hemodialysis in the "healthy" ESRD population?

Is this yet another example of the scarcity of common sense?

Take care. Linda Gromko, MD