Intensity of Continuous Renal-Replacement Therapy in Critically Ill Patients

• Published in: The New England journal of medicine Vol. 361; no. 17; pp. 1627 - 1638
• Main Authors: Bellomo, Rinaldo, Cass, Alan, Cole, Louise, Finfer, Simon, Gallagher, Martin, Lo, Serigne, McArthur, Colin, McGuinness, Shay, Myburgh, John, Norton, Robyn, Scheinkestel, Carlos, Su, Steve
• Format: Journal Article
• Language: English
• Published: Waltham, MA Massachusetts Medical Society 22.10.2009
• Subjects: Acute Kidney Injury - mortality; Acute Kidney Injury - therapy; Aged; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Consent; Critical Illness - mortality; Critical Illness - therapy; Drug therapy; Emergency and intensive care: renal failure. Dialysis management; Female; General aspects; Hemodiafiltration - adverse effects; Hemodiafiltration - methods; Humans; Intensive care medicine; Kaplan-Meier Estimate; Male; Medical sciences; Middle Aged; Mortality; Prospective Studies; Treatment Outcome; Human; Medicine; Extrarenal dialysis; Continuous; Critically ill; Intensity
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMoa0902413

This multicenter, randomized trial compared the effect of continuous renal-replacement therapy at two different levels of intensity on 90-day mortality among critically ill adults with acute kidney injury. The higher-intensity therapy did not reduce mortality at 90 days. This trial compared the effect of continuous renal-replacement therapy at two different levels of intensity on mortality among critically ill adults with acute kidney injury. The higher-intensity therapy did not reduce mortality at 90 days. Acute kidney injury is associated with substantial morbidity and mortality. 1 It is a common finding among patients in the intensive care unit (ICU) 2 and is an independent predictor of mortality. 3 Acute kidney injury severe enough to result in the use of renal-replacement therapy affects approximately 5% of patients admitted to the ICU and is associated with a mortality rate of 60%. 4 The optimal approach to renal-replacement therapy, as well as the optimal intensity and timing of such therapy, in critically ill patients remains unclear. In one single-center, randomized, controlled study in which continuous renal-replacement therapy was the sole treatment approach, . . .