Table 1.
Studies of Intensity of Renal Replacement Therapy in Acute Kidney Injury
| Study | N | Dose of RRT | Mortality | p-value | ||
|---|---|---|---|---|---|---|
| Less-Intensive Arm | More Intensive Arm | Less-Intensive Arm | More Intensive Arm | |||
| Conventional Intermittent Hemodialysis | ||||||
| Schiffl et al. (74) | 160 | Every-other day | Daily | 46%1 | 28%1 | 0.001 |
| Delivered Kt/V 0.94±0.11 | Delivered Kt/V 0.92±0.16 | |||||
| Prolonged Intermittent Hemodialysis | ||||||
| Faulhaber-Walter et al. (76) | 156 | Daily | 1–2 × per day | 44.4%2 | 38.7%2 | 0.47 |
| Target BUN: 56–70 mg/dL | Target BUN <42 mg/dL | |||||
| Continuous Renal Replacement Therapy | ||||||
| Ronco et al. (79) | 425 | CVVH: 20 ml/kg/hr | CVVH: 35 ml/kg/hr | 59%1 | 57%1 (35 mL/kg/hr) | <0.001 |
| CVVH: 45 ml/kg/hr | 58%1 (45 ml/kg/hr) | |||||
| Bouman et al. (19) | 106 | CVVH: 24–36 L/day | CVVH: 72–96 L/day | 25.7%2 | 28.2%2 | 0.80 |
| Saudan et al. (80) | 206 | CVVH | CVVHDF | 39%2 | 59%2 | 0.03 |
| QUF: 25±5 ml/kg/hr | QUF: 24±6 ml/kg/hr | |||||
| QD: 18±5 ml/kg/hr | ||||||
| Tolwani et al. (81) | 200 | CVVHDF: 20 ml/kg/hr | CVVHDF: 35 ml/kg/hr | 56%3 | 49%3 | 0.23 |
| Bellomo et al. (82) | 1,508 | CVVHDF: 25 ml/kg/hr | CVVHDF: 40 ml/kg/hr | 44.7%5 | 44.7%5 | 0.99 |
| Combined Modalities | ||||||
| Palevsky et al. (8) | 1,124 | IHD: 3x per week | IHD: 6x per week | 51.5%4 | 53.6%4 | 0.47 |
| Delivered Kt/V 1.32±0.37 | Delivered Kt/V 1.31±0.33 | |||||
| PIRRT: 3x per week | PIRRT: 6x per week | |||||
| CVVHDF: 20 ml/kg/hr | CVVHDF: 35 ml/kg/hr | |||||
1
mortality 15-days after discontinuation of study therapy;
2
28-day mortality;
3
30-day mortality;
4
60-day mortality;
5
90-day mortality;
RRT: renal replacement therapy; CVVH: continuous venovenous hemofiltration; CVVHDF: continuous venovenous hemodiafiltration; QUF: ultrafiltration rate; QD: dialysate flow rate; IHD: intermittent hemodialysis; PIRRT: prolonged intermittent renal replacement therapy