Slow low efficiency dialysis

“Slow low efficiency dialysis” refers to a type of dialysis treatment called “Sustained Low Efficiency Dialysis (SLED)”, which is a hybrid method between conventional intermittent hemodialysis (IHD) and continuous renal replacement therapy (CRRT), characterised by longer dialysis sessions with slower blood and dialysate flow rates, resulting in a less intensive but continuous removal of waste products from the blood, often used for critically ill patients with unstable blood pressure.

Key points about SLED:
Mechanism:
Unlike standard hemodialysis, SLED runs for a longer duration (typically 8-12 hours) with lower blood and dialysate flow rates, allowing for slower, more gentle waste removal.

Benefits:

• Hemodynamic stability: Considered gentler on the circulatory system, making it suitable for patients with unstable blood pressure.
• Flexible scheduling: Can be administered daily or over longer periods, allowing for better management of fluid balance.
• Potentially less anticoagulation needed: May not require as much blood thinning medication compared to CRRT.

When used:
SLED is often used in intensive care units for patients with acute kidney injury (AKI) who are hemodynamically unstable.