Intensity of Renal Support in Critically Ill Patients with Acute Kidney Injury

This randomized, controlled trial compared standard renal-replacement therapy with more intensive therapy in critically ill patients with acute kidney injury and failure of at least one nonrenal organ or sepsis. Intensive renal support did not decrease mortality, improve recovery of kidney function, or reduce the rate of nonrenal organ failure as compared with thrice-weekly intermittent hemodialysis. Intensive renal support did not decrease mortality, improve recovery of kidney function, or reduce the rate of nonrenal organ failure as compared with thrice-weekly intermittent hemodialysis. Acute kidney injury is a common complication of acute illness, affecting approximately 2 to 7% of hospitalized patients 1 – 4 and more than 35% of critically ill patients. 5 – 8 Renal-replacement therapy is the mainstay of supportive treatment of patients with severe acute kidney injury; its use is required in 5 to 6% of critically ill patients and is associated with in-hospital mortality rates of 50 to 80%. 5 , 9 – 12 The optimal timing for the initiation, method, and dosing of renal-replacement therapy remains uncertain more than 60 years after the first clinical use of hemodialysis in patients with acute kidney injury. 13 – . . .