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Critical Care
Published in: Critical Care 2/2011

01-04-2011 | Review

Clinical review: Optimal dose of continuous renal replacement therapy in acute kidney injury

Authors: John R Prowle, Antoine Schneider, Rinaldo Bellomo

Published in: Critical Care | Issue 2/2011

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Abstract

Continuous renal replacement therapy (CRRT) is the preferred treatment for acute kidney injury in intensive care units (ICUs) throughout much of the world. Despite the widespread use of CRRT, controversy and center-specific practice variation in the clinical application of CRRT continue. In particular, whereas two single-center studies have suggested survival benefit from delivery of higher-intensity CRRT to patients with acute kidney injury in the ICU, other studies have been inconsistent in their results. Now, however, two large multi-center randomized controlled trials - the Veterans Affairs/National Institutes of Health Acute Renal Failure Trial Network (ATN) study and the Randomized Evaluation of Normal versus Augmented Level (RENAL) Replacement Therapy Study - have provided level 1 evidence that effluent flow rates above 25 mL/kg per hour do not improve outcomes in patients in the ICU. In this review, we discuss the concept of dose of CRRT, its relationship with clinical outcomes, and what target optimal dose of CRRT should be pursued in light of the high-quality evidence now available.
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Metadata
Title
Clinical review: Optimal dose of continuous renal replacement therapy in acute kidney injury
Authors
John R Prowle
Antoine Schneider
Rinaldo Bellomo
Publication date
01-04-2011
Publisher
BioMed Central
Published in
Critical Care / Issue 2/2011
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc9415

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