Clinical Reviews: Sustained Low-Efficiency Daily Dialysis as Renal Replacement Therapy for the Critically Ill

Understanding proper management of acute kidney injury (AKI) is important given that studies consistently demonstrate an increasing incidence rate of AKI in the critically ill. AKI carries a significant risk for mortality, which only increases if dialysis becomes a necessary treatment. It is not clear whether modalities other than conventional intermittent hemodialysis improve outcomes in AKI. Sustained low-efficiency daily dialysis (SLEDD) is a more recent extracorporeal treatment whose distinguishing characteristic is its hybrid integration of both continuous and intermittent hemodialysis modalities. Besides providing comparable hemodynamic stability through its decreased blood flow rate and extended hours of use, SLEDD is less complicated, is less expensive, and is convenient for staff and patient. As a result, its use in critical care is on the rise.