Overview of RRT
Renal replacement therapy (RRT) is required when the kidneys are functioning at less than 10–15%. RRT is accomplished in one of the following ways:
People with advanced chronic renal failure (CRF) who have progressed to end-stage renal disease (ESRD) usually require dialysis. There are approximately 300,000 people on dialysis in the United States. Some patients require dialysis in the hospital or medical center, and others have home dialysis using devices (called dialyzers) that they are trained to operate.
People with advanced chronic renal failure are advised to prepare for dialysis before it is needed, instead of having to rely on it in a crisis. This may require having a fistula created in the forearm several months before it is to be used.
People who do not seek a nephrologist early or those who avoid preparation are at greater risk for short-term and long-term complication when they begin dialysis urgently.
The need for dialysis is indicated by various findings in blood analysis, such as a high creatinine level and high levels of nitrogen, and by a glomerular filtration rate that is, at most, 15 and usually less than 10. Pericarditis (inflammation of the sac that surrounds the heart) is associated with end-stage renal disease (ESRD) and indicates the need for dialysis.