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Title: Clinical review: Optimal dose of continuous renal replacement therapy in acute kidney injury.
Austin Authors: Prowle, John R;Schneider, Antoine G;Bellomo, Rinaldo 
Affiliation: Department of Intensive Care, Austin Health, 145 Studley Road, Heidelberg, Victoria 3084, Australia
Issue Date: 18-Mar-2011
Publication information: Critical Care 2011; 15(2): 207
Abstract: Continuous renal replacement therapy (CRRT) is the preferred treatment for acute kidney injury in intensive care units (ICUs) throughout much of the world. Despite the widespread use of CRRT, controversy and center-specific practice variation in the clinical application of CRRT continue. In particular, whereas two single-center studies have suggested survival benefit from delivery of higher-intensity CRRT to patients with acute kidney injury in the ICU, other studies have been inconsistent in their results. Now, however, two large multi-center randomized controlled trials - the Veterans Affairs/National Institutes of Health Acute Renal Failure Trial Network (ATN) study and the Randomized Evaluation of Normal versus Augmented Level (RENAL) Replacement Therapy Study - have provided level 1 evidence that effluent flow rates above 25 mL/kg per hour do not improve outcomes in patients in the ICU. In this review, we discuss the concept of dose of CRRT, its relationship with clinical outcomes, and what target optimal dose of CRRT should be pursued in light of the high-quality evidence now available.
Gov't Doc #: 21489322
DOI: 10.1186/cc9415
Type: Journal Article
Subjects: Acute Kidney Injury.therapy
Dose-Response Relationship, Drug
Evidence-Based Medicine
Intensive Care.methods
Randomized Controlled Trials as Topic
Renal Replacement Therapy.methods
Treatment Outcome
Appears in Collections:Journal articles

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