Acute renal failure (ARF) patients require some form of renal replacement therapy to stabilize their condition and to promote recovery. In today’s clinical environment, providers need renal care solutions that enhance quality of care, control costs and reduce the burden on critical care staff. NxStage is helping to lead the way.

The Acute Renal Care Challenge

As many as 15% of patients admitted to critical care units suffer from ARF.1 Mortality is high:  50%–90% in the postoperative or critically ill patient with multi-organ failure.2  However, if the patient survives, kidney function generally returns.

Acute renal failure differs dramatically from chronic renal failure. Patients are often extremely catabolic, generating toxins at a much faster rate than those with chronic renal failure. In addition, toxins are more widely distributed across the body. Blood purification therapy is required to stabilize the patient until kidney function returns.

A growing body of literature suggests that patients with acute renal failure should be treated differently than chronic outpatients. However, the same intermittent therapies delivered to chronic patients are also the most prevalent treatment for patients with acute renal failure. And, ironically, targeted doses are on average not even achieved.

Recent randomized clinical trial data support the need for more intensive Continuous Renal Replacement Therapy (CRRT) for ARF patients:

• In a 160-patient study of daily vs. intermittent hemodialysis, mortality was reduced by 40% in the daily therapy arm.3
• In a 425-patient study of continuous (CRRT) patients, mortality was reduced by 30% when the volume of therapy delivered daily was increased by 75%.4
• In addition, a 40-patient study showed extended daily therapies to have many of the stability benefits of CRRT in a simpler mode of administration.5

More therapy generally means more work - labor, fluid handling, charting - for ICU nurses. This is not feasible in today's environment. The nursing shortage is at a crisis level and is impacting patient outcomes7,8. Currently available equipment - conventional hemodialysis and dedicated critical care - both present challenges as therapy frequency and volume are increased.

For ICU patients in renal failure, the evidence supporting early initiation of high-dose therapies is compelling. But how can you deliver those therapies without overwhelming your ICU staff?

The NxStage System One is designed from the ground up to make intensive, CRRT therapies surprisingly simple.