Table 1. Overview of Dosing Trials in Aki.
Study Design & Location | No. of patients | RRT Modality | Replacement Solution & Administration | Dose calculation & Prescribed dose | ||||
---|---|---|---|---|---|---|---|---|
Continuous renal replacement therapy trials | ||||||||
Ronco et al13 | single center RCT; Italy | 425 | CVVH | Lactate; Post-filter | Effluent flow rate; 20mL/kg/hr vs. 35mL/kg/hr vs. 45 mL/kg/hr | |||
Bouman et al15 | 2 center RCT; The Netherlands | 106 | CVVH | Bicarbonate; Post-filter | Effluent flow rate; 19 mL/kg/hr vs. 48mL/kg/hr | |||
Saudan et al16 | single center RCT; Switzerland | 206 | CVVH /CVVH DF | Lactate and bicarbonate; Post-filter | Effluent flow rate; CVVH – 25mL/kg/hr CVVHDF – 42mL/kg/hr | |||
Tolwani et al17 | single center RCT; USA | 200 | CVVHD F | Bicarbonate; Pre-filter | Effluent flow rate; 20mL/kg/hr vs. 35mL/kg/hr | |||
Bellomo et al19 | multicenter RCT; Australia, NZ | 1,508 | CVVHD F | Bicarbonate; Post-filter | Effluent volume; 25mL/kg hr vs. 40mL/kg/hr | |||
Intermittent hemodialysis trial | ||||||||
Schiffl et al14 | single center Alt Assign,; Germany | 160 | IHD | NA | Kt/Vurea and frequency of IHD; Kt/Vurea of 1.2 per IHD every other day vs daily | |||
Extended dialysis trial | ||||||||
Faulhaber-Walter et al20 | multicenter RCT; Germany | 156 | ED | NA | Plasma urea level 120-150 mg/dl vs. <90 mg/dl | |||
Combination modality trial | ||||||||
Palevsky et al18 | multicenter RCT; USA | 1,124 | IHD, SLED, CVVHD F | Bicarbonate; Pre-filter | Kt/Vurea and Effluent volume; Kt/Vurea of 1.3 in IHD and SLED – 3 vs. 6 times/wk;Effluent Volume, 20mL/kg/hr vs. 35mL/kg/hr |
Alt Assign – alternate assignment; CVVH – continuous venovenous hemofiltration; CVVHDF – continuous venovenous hemodiafiltration; ED – extended dialysis; SLED – sustained low efficiency dialysis; IHD – intermittent hemodialysis; NA -- Not applicable; RCT – randomized controlled trial; All trials controlled for severity of illness using APACHE II or III or SOFA scoring.