The future of critical care: Renal support in 2027

William R. Clark, Mauro Neri, Francesco Garzotto, Zaccaria Ricci, Stuart L. Goldstein, Xiaoqiang Ding, Jiarui Xu, Claudio Ronco

Research output: Contribution to journalReview articlepeer-review


Since its inception four decades ago, both the clinical and technologic aspects of continuous renal replacement therapy (CRRT) have evolved substantially. Devices now specifically designed for critically ill patients with acute kidney injury are widely available and the clinical challenges associated with treating this complex patient population continue to be addressed. However, several important questions remain unanswered, leaving doubts in the minds of many clinicians about therapy prescription/delivery and patient management. Specifically, questions surrounding therapy dosing, timing of initiation and termination, fluid management, anticoagulation, drug dosing, and data analytics may lead to inconsistent delivery of CRRT and even reluctance to prescribe it. In this review, we discuss current limitations of CRRT and potential solutions over the next decade from both a patient management and a technology perspective. We also address the issue of sustainability for CRRT and related therapies beyond 2027 and raise several points for consideration.

Original languageEnglish
Article number92
JournalCritical Care
Issue number1
Publication statusPublished - Apr 11 2017

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine


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