Current status of dosing and quantification of acute renal replacement therapy. Part 1: mechanisms and consequences of therapy under-delivery.

The dosing and quantification of acute renal replacement therapy has emerged as one of the most pressing issues in the management of critically-ill patients with acute kidney injury. Although there is ongoing debate as to the best marker of uraemic injury in this setting, several landmark studies have identified clearance-related expressions of acute renal replacement therapy dose as important determinants of survival. Part 1 of this review examines the factors affecting delivery of prescribed acute renal replacement therapy dose. The review continues in Part 2 and examines the implications of recent advances in this area for clinical practice.