Intensity of continuous renal-replacement therapy in critically ill patients.

摘要: Background The optimal intensity of continuous renal-replacement therapy remains unclear. We conducted a multicenter, randomized trial to compare the effect this therapy, delivered at two different levels intensity, on 90-day mortality among critically ill patients with acute kidney injury. Methods randomly assigned adults injury in form postdilution venovenous hemodiafiltration an effluent flow either 40 ml per kilogram body weight hour (higher intensity) or 25 (lower intensity). primary outcome measure was death within 90 days after randomization. Results Of 1508 enrolled patients, 747 were higher-intensity and 761 lower-intensity hemodiafiltration. Data outcomes available for 1464 (97.1%): 721 group 743 group. study groups had similar baseline characteristics received treatment average 6.3 5.9 days, respectively (P = 0.35). At randomization, 322 deaths occurred 332 group, 44.7% each (odds ratio, 1.00; 95% confidence interval [CI], 0.81 1.23; P 0.99). 6.8% survivors (27 399), as compared 4.4% (18 411), still receiving 1.59; CI, 0.86 2.92; 0.14). Hypophosphatemia more common than (65% vs. 54%, Conclusions In injury, did not reduce days. (ClinicalTrials.gov number, NCT00221013.)