In the intensive care unit (ICU) setting, continuous renal replacement therapy (CRRT) is performed in acute renal failure (ARF), while plasmapheresis is performed in fulminant hepatitis (FH) and other conditions.

Acute renal failure (ARF)

In acute renal failure (ARF), homeostasis of body fluids and electrolytes cannot be maintained within a few days following the sudden loss of renal function. The most common symptoms are uremia, hyperkalemia, acidosis, and plethora. In most cases, if the underlying cause of renal failure is eliminated, original renal function can be recovered. CRRT is an effective supportive method until renal function recovery.

Fulminant hepatitis (FH)

Fulminant hepatitis (FH) and acute hepatic failure show symptoms of hepatic failure including hepatic encephalopathy due to severe liver dysfunction caused by sudden, extensive hepatocyte necrosis. FH and acute hepatic failure are extremely critical, life-threatening conditions posing difficulties even in the critical care/ICU setting. Plasmapheresis and CRRT are performed to provide artificial liver support (ALS). ALS significantly improves outcome in systemic conditions including disorders of consciousness. It is also used as a bridge to liver transplantation.

Hemolytic uremic syndrome (HUS)

Hemolytic uremic syndrome (HUS) is a syndrome accompanied by hemolytic anemia, decreased platelet count, and ARF. Plasmapheresis is performed to reduce uremic toxins in the plasma, while CRRT is performed to control body fluid levels.