Table 1

Indications and Contraindications to Common Renal Replacement

Therapies
Renal Indications Contraindications
Replacement
Therapy
Hemodialysis Renal insufficiency or failure Uncooperative or
(acute or chronic) with any of the hemodynamically
following that cannot otherwise be unstable patient
controlled:
Fluid overload
Hyperkalemia
Hypercalcemia
Metabolic acidosis
Pericarditis
Uremic symptoms
GFR < 10 mL/min/1.73 m2 BSA
(chronic renal failure, no diabetes)
GFR < 15 mL/min/1.73 m2 BSA
(chronic renal failure, diabetes)
Some poisonings (see Poisoning)
Peritoneal Same indications as for Absolute: Loss of
dialysis hemodialysis (except for peritoneal function or
poisonings) in patients who: adhesions that limit
Have inadequate vascular access dialysate flow, recent
or abdominal wounds,
Prefer self-therapy abdominal fistulas,
abdominal wall defects
that prevent effective
dialysis or increase
infection risk (eg,
irreparable inguinal or
diaphragmatic hernia,
bladder extrophy),
patient's condition not
amenable to dialysis
Relative: Abdominal
wall infection, frequent
episodes of diverticulitis,
inability to tolerate large
volumes of peritoneal
dialysate, inflammatory
bowel disease, ischemic
colitis, morbid obesity,
 peritoneal leaks, severe
undernutrition
Hemoperfusion Poisoning or toxicity (eg, due to Uncooperative or
barbiturates, many antidepressants, hemodynamically
ethchlorvynol,meprobamate  unstable patient

, paraquat, glutethimide, metals

such aslithium 

and barium, toxic doses of

aminoglycosides or cardiovascular
drugs)

BSA = body surface area.

For calculation of GFR see Approach to the Genitourinary Patient: GFR