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Continuous renal replacement therapy (CRRT) is often associated with sepsis or a toxic cause and \u201ckidney attack\u201d not apparent to the patient; \u201csilent\u201d with no pain, discomfort, or vital sign changes initially. Language, terminology, and definitions for this acute kidney injury (AKI) are a graded classification with guidelines.<\/jats:p><jats:p>CRRT and dialysis techniques use the physiological principles of diffusion and or convection for solute removal providing a replacement for the basic kidney functions to sustain life until function returns. When to stop CRRT is based on clinical assessment of the patient overall status and urine production re\u2010starting.<\/jats:p><jats:p>The medical treatment is focused on the key interventions of resuscitation, remove the cause, support with CRRT or dialysis and monitor for recovery of function. 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