New chapters in the McMaster Textbook of Internal Medicine: Renal Replacement Therapy

Renal replacement therapy (RRT), more commonly known as dialysis, is a therapy for the treatment of renal failure, both in severe acute kidney injury (AKI) and end-stage renal disease (ESRD), and in certain types of poisonings or overdoses. The dialysis modalities can be broadly classified into extracorporeal dialysis and peritoneal dialysis.

“Extracorporeal dialysis involves filtering the circulating blood through a semipermeable membrane in an apparatus outside of the patient’s body.

In peritoneal dialysis, dialysate is instilled into the peritoneal cavity; solutes diffuse from peritoneal capillaries, across the interstitium and mesothelium, into the dialysate. Ultrafiltration of fluid is achieved through an osmotic gradient created by the use of hypertonic dialysate, such as dextrose (glucose monohydrate).”

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