Table 3: Theoretical advantages and disadvantages of different renal replacement modalities.

Techniques Solute transport Duration of therapy/session (hr.) Advantages Disadvantages
IHD Diffusion 4 - Rapid removal of uremic toxins and
small molecule clearance
- Technically simple
- Relatively low cost
- Patients mobility
- Increased risk of hypotension and
disequilibrium
- Require vascular access and
anticoagulant
PD Diffusion 24 - Technically simple
- Require less infrastructure
- No anticoagulation required
- Less hemodynamic instability
- Relatively low cost
- Slow small molecule and uremic
toxin clearance
- Unpredictable fluid removal
- Risk of peritonitis
- May compromise respiratory function
PIRRT Diffusion 6-12 - More rapid solutes and uremic toxin
removal than CRRT, but slower than IHD
- More hemodynamically stable than IHD
- Technically simple
- Relatively low cost
- Patients mobility
- Require vascular access and anticoagulant
- Risks of hypotension and disequilibrium
CVVHF Convection 24 - Increased middle molecule and cytokines
removal from convective technique
- Continuous removal of uremic toxins and fluid
- More hemodynamically stable than IHD
- Complex circuit
- High cost
- Require vascular access and anticoagulant
and prolonged use of anticoagulant
- Patient immobility
CVVHD Diffusion 24 - Continuous removal of uremic toxins
and fluid
- More hemodynamically stable than IHD
- Complex circuit
- High cost
- Require vascular access and anticoagulant
and prolonged use of anticoagulant
- Patient immobility
CVVHDF Diffusion and convection 24 - Increased middle molecule and cytokines
removal from convective technique
- Continuous removal of uremic toxins
and fluid
- More hemodynamically stable than IHD
- Complex circuit
- High cost
- Require vascular access and anticoagulant
and prolonged use of anticoagulant
- Patient immobility

IHD: Intermittent Hemodialysis; PD: Peritoneal Dialysis; PIRRT: Prolonged Intermittent Renal Replacement Therapy; CVVHF: Continuous Venovenous Hemofiltration; CVVHD: Continuous Venovenous Hemodialysis; CVVHDF: Continuous Venovenous Hemodiafiltration.