What question did this study set out to answer?

To evaluate whether intensive renal-replacement therapy reduces mortality and enhances organ recovery compared with less-intensive therapy in critically ill patients with acute kidney injury.

May 20, 2008New England Journal of MedicineOpen Access

Intensity of Renal Support in Critically Ill Patients with Acute Kidney Injury

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TNThe VA/NIH Acute Renal Failure Trial Network

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Implication

Randomized trial finds intensive renal support does not reduce 60-day mortality in critically ill acute kidney injury, indicating standard dosing is sufficient.

Key Points

To evaluate whether intensive renal-replacement therapy reduces mortality and enhances organ recovery compared with less-intensive therapy in critically ill patients with acute kidney injury.
Randomized trial (NCT00076219) of 1,124 critically ill patients with acute kidney injury and failure of at least one nonrenal organ or sepsis.
Patients were assigned to intensive renal support (intermittent hemodialysis/SLED 6 times per week or CVVHDF at 35 ml/kg/h) or less-intensive support (thrice weekly or 20 ml/kg/h).
The rate of death from any cause by day 60 was 53.6% with intensive therapy versus 51.5% with less-intensive therapy (odds ratio, 1.09; 95% CI, 0.86 to 1.40; P=0.47).
Duration of renal-replacement therapy and rates of kidney function recovery and nonrenal organ failure resolution did not differ significantly between groups.
More patients assigned to intensive therapy experienced hypotension during intermittent dialysis, though the per-session frequency of hypotension was similar between groups.

Cite This Study

The VA/NIH Acute Renal Failure Trial Network (2008) studied this question.

synapsesocial.com/papers/6a6ff580f44fa9f079dd76d3 https://doi.org/10.1056/nejmoa0802639

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Implication

Randomized trial finds intensive renal support does not reduce 60-day mortality in critically ill acute kidney injury, indicating standard dosing is sufficient.

Intensity of Renal Support in Critically Ill Patients with Acute Kidney Injury

Discussion

Member takes

Implication

Key Points

Cite This Study

Intensity of Renal Support in Critically Ill Patients with Acute Kidney Injury

Discussion

Member takes

Implication

Key Points

Cite This Study

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