Sustained Low-Efficiency Dialysis (SLED) and Hybrid Therapies in Children

  • Valentine Lobo


A wide variation in renal replacement therapy practices for critically ill patients with acute kidney injury exists across the world, with continuous renal replacement therapy (CRRT) predominating in developed countries and peritoneal dialysis in developing countries. Sustained low efficiency dialysis is a technical hybrid, combining the ease of use and low costs of intermittent hemodialysis with the hemodynamic stability of CRRT. It is performed using conventional hemodialysis machines and dialyzers, without anticoagulation where necessary. Current studies have shown similar efficacy results with SLED and CRRT. The use of ultrapure water and sterile dialysate produced by cold sterilization have enabled the addition of a convective clearance to diffusion with improved survival in small studies. As a hybrid therapy, great flexibility has been shown in coupling SLED with other extracorporeal treatments.


SLEDD PIRRT Hemodynamic stability Ultrafiltration Hypotension Survival convective clearance 


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© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Valentine Lobo
    • 1
  1. 1.Department of NephrologyKing Edward Memorial HospitalPuneIndia

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