Less Is More with Dialysis in Patients with Severe Acute Kidney Injury

Clinical Takeaway

: In a randomized trial, patients recovered kidney function more rapidly and more often when they received dialysis as needed rather than thrice weekly.

Context

When hospitalized patients with acute kidney injury (AKI) require renal replacement therapy, they often receive thrice-weekly dialysis. However, this approach can mask recognition of improving renal function and might even perpetuate renal injury. This study examined a less-intensive, conservative approach. Researchers randomized into two groups 221 hemodynamically stable, nonintubated patients with AKI who had initiated dialysis. The conservatively treated group received hemodialysis or ultrafiltration only when they reached specified thresholds for serum urea nitrogen levels, hyperkalemia, acidosis, or pulmonary edema related to volume overload. The conventionally treated group received thrice-weekly hemodialysis until they had doc…

Reviewing Author

Meghan Sise, M.D., M.S.

Guest Author

Dr. Sise is Director of Onconephrology at Massachusetts General Hospital and Associate Professor of Medicine at Harvard Medical School in Boston.

Meghan Sise, M.D., M.S.

Guest Author

Dr. Sise is Director of Onconephrology at Massachusetts General Hospital and Associate Professor of Medicine at Harvard Medical School in Boston.

Less Is More with Dialysis in Patients with Severe Acute Kidney Injury

Topics

Clinical Takeaway

Context

Reviewing Author