Utilization of continuous renal replacement therapy in a case of feline acute renal failure

Objective: To introduce and investigate the application, efficacy, and potential clinical complications of a continuous renal replacement therapy (CRRT) in a feline acute renal failure (ARF) patient. Case summary: A domestic short-haired cat presented for continued management of ARF of a presumed toxic etiology. Severe azotemia and uremic complications had been identified on initial presentation to a local urgent care facility, and the cat had been referred for renal replacement therapy following approximately 9 hours of conservative management. Continuous venovenous hemodiafiltration was performed over an approximately 25-hour period, and a significant resolution of the cat's uremic derangements was obtained. Major complications included significant hypothermia and a single episode of hypocalcemia associated with utilization of citrate anticoagulation. All complications identified were readily managed. Following hospital discharge, long-term medical support was not required, and no evidence of significant illness was noted 6 months following therapy. New or unique information provided: CRRT represents a collection of extracorporeal blood purification techniques that utilize extended treatment periods for gradual, physiologically balanced correction of uremic toxicity. These therapies demonstrate significant promise in the treatment of ARF cats with actual or potential hemodynamic compromise, and prior advances in therapeutic administration have made these techniques readily accessible within the intensive care unit setting.