Daily Hemodialysis and the Outcome of Acute Renal Failure

Schiffl, Helmut; Lang, Susanne M.; Fischer, Rainald

doi:10.1056/nejmoa010877

Cited by 750 publications

(406 citation statements)

References 14 publications

Supporting

Mentioning

350

Contrasting

Unclassified

Order By: Relevance

“…Our study demonstrated a shorter duration of ICU stay and a trend for a shorter duration of RRT with the lower-volume protocol, in contrast to previous reports, where high-volume therapy was associated with a shorter duration of RRT, ICU stay and/or ventilatory support [1,4]. In our study, this difference is most likely to reflect differences between the two cohorts rather than an effect of the RRT protocol switch; the low-volume cohort had a higher incidence of CKD at baseline, and fewer patients required ventilatory support.…”

Section: Discussioncontrasting

confidence: 99%

Clinical and economic impact of a switch from high‐ to low‐volume renal replacement therapy in patients with acute kidney injury

et al. 2014

View full text Add to dashboard Cite

SummaryHigh-intensity renal replacement therapy protocols in intensive care patients with acute kidney injury have failed to translate to improved patient outcomes when compared with lower-intensity protocols. This retrospective study explored the clinical and economic impacts of switching from a 30-35 ml.kg À1 .h À1 (high-volume) to a 20 ml.kg À1 .h À1 (low-volume) protocol. Patients (n = 366) admitted 12 months before (n = 187) and after (n = 179) the switch were included in the study. There was no difference in in-hospital mortality (77/187 (41%) vs 75/179 (42%), respectively, p = 0.92), intensive care unit mortality (55/187 (29%) vs 61/179 (34%), respectively, p = 0.40), duration of organ support or extent of renal recovery between the high-and low-volume cohorts. A 25% reduction in daily replacement fluid usage was observed, equating to a cost saving of over £27 000 per annum. In conclusion, a switch from high-to lowvolume continuous haemodiafiltration had minimal effects on clinical outcomes and resulted in marked cost savings.

show abstract

Section: Discussioncontrasting

confidence: 99%

Clinical and economic impact of a switch from high‐ to low‐volume renal replacement therapy in patients with acute kidney injury

et al. 2014

View full text Add to dashboard Cite

show abstract

“…Therefore, leptospirosis is a near-perfect human model of sepsis. Schiffl et al (9) reported that daily intermittent hemodialysis is superior to conventional (alternate-day) hemodialysis in critically ill patients with AKI and concomitant acute tubular necrosis. The authors found that daily hemodialysis was associated with better control of blood urea nitrogen and creatinine, as well as with higher survival rates.…”

Section: Discussionmentioning

confidence: 99%

Door-to-Dialysis Time and Daily Hemodialysis in Patients with Leptospirosis

Andrade

Cleto

Seguro

2007

Clinical Journal of the American Society of Nephrology

View full text Add to dashboard Cite

Background: Leptospirosis is a public health problem, the severe form of which (Weil's disease) includes acute respiratory distress syndrome, typically accompanied by acute kidney injury (AKI), and is associated with high mortality rates. Recent evidence suggests that dialysis dosage affects outcomes in critically ill patients with sepsis-induced AKI. However, this population varies widely in terms of age, gender, and concomitant conditions, making it difficult to determine the appropriate timing (door-to-dialysis time) and dialysis dosage.Design, setting, participants, and measurements: It is logical to assume that increasing the dialysis dosage would minimize uremic complications and improve outcomes in such patients. Patients with Weil's disease constitute a homogeneous population and are typically free of comorbidities, therefore presenting an ideal model in which to test this assumption.Results Conclusions: On the basis of this result, it is believed that alternate-day hemodialysis is no longer appropriate for critically ill patients with Weil's disease.

show abstract

“…Survival did not significantly differ between groups 2 and 3 (P Ͼ 0.2). Moreover, Schiffl and colleagues (112) recently reported that among 160 consecutive patients alternately assigned to daily or alternate-day hemodialysis with a biocompatible membrane (high-flux polysulfone or AN 69), mortality was reduced from 46% to 28% with daily dialysis (P ϭ 0.01). The weekly delivered dose of dialysis was greater for the daily group than for the alternate-day group.…”

Section: Initiation and Dosementioning

confidence: 99%