International renal interest society best practice consensus guidelines for intermittent hemodialysis in dogs and cats

Gilad Segev*, Jonathan D. Foster, Thierry Francey, Catherine Langston, Ariane Schweighauser, Larry D. Cowgill

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review


Intermittent hemodialysis (IHD) is an advanced adjunctive standard of care for severe acute kidney injury (AKI) and other indications. Most animals with AKI are managed medically, however, when the disease is severe, medical management may not control the consequences of the disease, and animals with a potential for renal recovery may die from the consequences of uremia before recovery has occurred. Extracorporeal therapies aid the management of AKI by expanding the window of opportunity for recovery of sufficient kidney function to become dialysis independent. Intermittent hemodialysis (IHD) was introduced into veterinary medicine over 50 years ago, however, updated guidelines for the delivery of IHD have not been published for several decades. To that end, the International Renal Interest Society (IRIS) constituted a Working Group to establish best practice guidelines for the safe and effective delivery of IHD to animals with indications for dialytic intervention. The IRIS Working Group generated 60 consensus statements and supporting rational for a spectrum of prescription and management categories required for delivery of IHD on designated intermittent dialysis platforms (i.e., AKI, chronic hemodialysis and intoxications). A formal consensus method was used to validate the recommendations by a blinded jury of 12 veterinarians considered experts in extracorporeal therapies and actively performing IHD. Each vote provided a level of agreement for each recommendation proposed by the Working Group. To achieve a consensus, a minimum of 75% of the voting participants had to “strongly agree” or “agree” with the recommendation.

Original languageAmerican English
Article number106092
JournalVeterinary Journal
StateAccepted/In press - 2024

Bibliographical note

Publisher Copyright:
© 2024 The Authors


  • Acute kidney injury
  • Canine
  • Extracorporeal
  • Feline
  • Hemodialysis


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