Renal Replacement Therapy in Critically Ill Patients with Acute Kidney Injury

In relatively small studies in which more-intensive and less-intensive dialysis regimens were compared in critically ill patients with acute renal failure, results have been mixed. In a large multicenter trial, conducted at U.S. veterans’ hospitals, researchers have again addressed this issue.

The study involved 1124 critically ill adults who had acute kidney injury consistent with acute tubular necrosis, plus either sepsis or failure of another organ system. Patients were randomized to receive intermittent hemodialysis either six times weekly (intensive strategy) or three times weekly (less-intensive strategy); during intervals of hemodynamic instability, patients in both groups received continuous venovenous hemodiafiltration or sustained …