Authors: Helmut Schiffl
Publish Date: 2010/04/10
Volume: 42, Issue: 2, Pages: 435-440
Abstract
The impact of intensity or dose of renal replacement therapy RRT on outcome of critically ill patients has been a matter of controversy Most definitions of an adequate dose of acute RRT are based on urea removal while ignoring other crucial aspects of RRT adequacy in acute kidney injury AKI Although some clinical trials have found an improvement in survival with higher doses of intermittent hemodialysis or continuous RRT results have not been consistent across all studies The largest trials suggest that there is no additional survival benefit with doses of 35–45 ml/kg/h CRRT or daily intermittent hemodialysis On the other hand highintensity treatment may cause lifethreatening complications and thereby counteract the benefits of higher smallsolute clearance One important area for future investigations is the need to characterize the potential harm of highdose RRT for AKI in critically ill patients
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