Continuous versus intermittent renal replacement therapy: a meta-analysis

Kellum, John A.; Angus, Derek C.; Johnson, John P.; Leblanc, Martine; Griffin, Martin F.; Ramakrishnan, Nagarajan; Linde-Zwirble, Walter T.

doi:10.1007/s00134-001-1159-4

Cited by 335 publications

(169 citation statements)

References 26 publications

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“…Two RCTs comparing IRRT with CRRT in ARF have been published, and these report results that are inconclusive for the major end-point [8,9], and a further RCT is underway in France [10]. A recent meta-analysis using randomized or observational studies suggested that CRRT is associated with a lower rate of hospital mortality than IRRT [11]. In the present study we extracted from our large database [2] those ARF patients who required RRT with the following two specific objectives: (a) to describe the characteristics of the patients according to the RRT modality used and (b) to assess the extent to which the RRT mode affects patient outcome.…”

Section: Introductionmentioning

confidence: 99%

Intermittent versus continuous renal replacement therapy for acute renal failure in intensive care units: results from a multicenter prospective epidemiological survey

Guérin

Girard

Selli

et al. 2002

Intensive Care Medicine

123

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Section: Introductionmentioning

confidence: 99%

Intermittent versus continuous renal replacement therapy for acute renal failure in intensive care units: results from a multicenter prospective epidemiological survey

Guérin

Girard

Selli

et al. 2002

Intensive Care Medicine

123

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“…der Letalität von Patienten, welche mit kontinuierlichen (CVVH) vs. intermittierenden (IHD) Nierenersatzverfahren behandelt worden waren [23,37]. Es fand sich selbst dann kein Unterschied, wenn ausschließlich randomisierte Studien berücksichtigt wurden [37].…”

Section: Kontinuierliche Vs Intermittierende Nierenersatzverfahrenunclassified

Supportive und adjunktive Therapie der Sepsis

Brunkhorst

Reinhart

2009

Internist

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Severe sepsis and septic shock have an increasing incidence but an unchanged mortality. It has been demonstrated that the time until the start of supportive therapy affects the progress of multiorgan failure and patient outcome. Early goal-directed therapy guided by central venous oxygen saturation is associated with a significant reduction in mortality, as is the use of lung-protective mechanical ventilation and recombinant activated protein C (rhAPC) in eligible patients. The use of starches for volume resuscitation, low-dose dopamine and hydrocortison as well as an intensive insulin protocol for restoration of euglycemia is not recommended. The German Competence Network Sepsis (SepNet) is currently studying further relevant questions.

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“…We sentliche Veränderungen erfuhren auch die Therapiekonzepte in Bezug auf den "optimalen" Zeitpunkt für den Beginn einer Therapie bei einsetzendem ANV und in Bezug auf die Empfehlungen für die Dosierungen [6]. Dennoch sind evi denzbasierte Richtlinien zur Behandlung des ANV mit extrakorporalen Nierener satzverfahren derzeit aus Mangel an ent sprechenden randomisierten kontrollier ten Studien nicht verfügbar [7].…”

Section: Nierenersatzverfahren Auf Der Intensivstationunclassified

Nierenersatzverfahren auf der Intensivstation

et al. 2007

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Acute renal failure is a common complication in intensive care medicine. While the incidence of acute renal failure increases, mortality still remains at a high level. In Europe continuous renal replacement therapy (CRRT) has become the standard treatment for acute renal failure. Continuous renal replacement therapy has the advantage of achieving a more stable haemodynamic situation and an easier volume management compared to intermittent haemodialysis (IHD). Until now there has been no evidence to suggest that either classical IHD or CRRT is superior in reducing mortality. Using CRRT in patients with acute renal failure, an ultrafiltration rate adjusted to the patient's bodyweight at 35 ml/kg x h is recommended. A new approach in renal replacement therapy is the slow extended daily dialysis (SLEDD), which combines the advantages of CRRT and IHD. First results are promising, but further investigations are needed to show whether outcome can be improved. A final evidence-based recommendation on the dosing of CRRT or a definitive answer to the question whether daily IHD is better than CRRT, can probably only be possible after two running multicentre studies, the VA/NIH Acute Renal Failure Trial Network (ATN) study and the Augmented Versus Normal Renal Replacement Therapy in Severe Acute Renal Failure Study (ANZICS 2005) Australia and New Zealand Intensive Care Group.

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Continuous versus intermittent renal replacement therapy: a meta-analysis

Abstract: Current evidence is insufficient to draw strong conclusions regarding the mode of replacement therapy for acute renal failure in the critically ill. However, the life-saving potential with CRRT suggested in our secondary analyses warrants further investigation by a large, randomized trial.

Cited by 335 publications

References 26 publications

Intermittent versus continuous renal replacement therapy for acute renal failure in intensive care units: results from a multicenter prospective epidemiological survey

Intermittent versus continuous renal replacement therapy for acute renal failure in intensive care units: results from a multicenter prospective epidemiological survey

Supportive und adjunktive Therapie der Sepsis

Nierenersatzverfahren auf der Intensivstation

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