open access

Vol 48, No 3 (2016)
Review articles
Published online: 2016-05-31
Submitted: 2016-05-07
Accepted: 2016-05-22
Get Citation

Validity of low-efficacy continuous renal replacement therapy in critically ill patients

Hiroo Kawarazaki, Shigehiko Uchino
DOI: 10.5603/AIT.a2016.0029
·
Anaesthesiol Intensive Ther 2016;48(3):191-196.

open access

Vol 48, No 3 (2016)
Review articles
Published online: 2016-05-31
Submitted: 2016-05-07
Accepted: 2016-05-22

Abstract

The 1980s saw the use of continuous arteriovenous hemofiltration whose intensity hemofiltration rate was only 3 or 4 mL kg-1 h-1. With the installation of a blood pump, this dose went up to 8 or 10 mL kg-1 h-1, and continued to increase, reaching about 20 mL kg-1 h-1 by the year 2000. Some studies found that a higher dose could be beneficial, and the world rapidly followed the trend, increasing the dose up to 35 mL kg-1 h-1. Then, two randomized control trials, namely the VA/NIH Acute Renal Failure Trial Network study and the RENAL study, came along in succession which changed the Kidney Disease: Improving Global Outcomes (KDIGO) recommendation to 20 to 25 mL kg-1 h-1. However, no good evidence exists to support this. Our recent multicenter retrospective studies from the JSEPTIC CRRT database show that the Japanese continuous renal replacement therapy dose of (14.3 mL kg-1 h-1) does not seem to have worse outcomes when compared with a higher dose.

Abstract

The 1980s saw the use of continuous arteriovenous hemofiltration whose intensity hemofiltration rate was only 3 or 4 mL kg-1 h-1. With the installation of a blood pump, this dose went up to 8 or 10 mL kg-1 h-1, and continued to increase, reaching about 20 mL kg-1 h-1 by the year 2000. Some studies found that a higher dose could be beneficial, and the world rapidly followed the trend, increasing the dose up to 35 mL kg-1 h-1. Then, two randomized control trials, namely the VA/NIH Acute Renal Failure Trial Network study and the RENAL study, came along in succession which changed the Kidney Disease: Improving Global Outcomes (KDIGO) recommendation to 20 to 25 mL kg-1 h-1. However, no good evidence exists to support this. Our recent multicenter retrospective studies from the JSEPTIC CRRT database show that the Japanese continuous renal replacement therapy dose of (14.3 mL kg-1 h-1) does not seem to have worse outcomes when compared with a higher dose.

Get Citation

Keywords

acute kidney injury, critically ill, CRRT intensity

About this article
Title

Validity of low-efficacy continuous renal replacement therapy in critically ill patients

Journal

Anaesthesiology Intensive Therapy

Issue

Vol 48, No 3 (2016)

Pages

191-196

Published online

2016-05-31

DOI

10.5603/AIT.a2016.0029

Bibliographic record

Anaesthesiol Intensive Ther 2016;48(3):191-196.

Keywords

acute kidney injury
critically ill
CRRT intensity

Authors

Hiroo Kawarazaki
Shigehiko Uchino

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

VM Media sp. z o.o. VM Group sp.k., Grupa Via Medica, Świętokrzyska 73 St., 80–180 Gdańsk

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail: viamedica@viamedica.pl