Continuous Renal Replacement Therapy Quality Control and Performance Measures

Abstract

Continuous renal replacement therapy (CRRT) is one of the most predominant forms of renal replacement therapy (RRT) currently in use now, this therapy being the initial RRT modality in most critically ill patients. However, in general, the quality of CRRT is still suboptimal. The quality of CRRT is affected by many factors, including the optimal prescription and precision delivery, the CRRT providers' professional level, and the CRRT device used. Establishment of a comprehensive quality control system covering all the aspects and procedures of CRRT is essential. Quality measures for structure, process, and outcome of CRRT need to be developed, evaluated, and implemented to ensure the high quality of CRRT. Some CRRT quality improvement methods such as the professional education and specialized team and the application of citrate anticoagulation to extend filter lifespan have been found to be potentially beneficial but need further validation. After all, much work is needed in this field because of the heterogeneity in CRRT practice. More evidence is needed to improve the CRRT quality control system. These are challenges that will need to be addressed in the future.