ArticleCritical care (London, England)2009
Delivered dose of renal replacement therapy and mortality in critically ill patients with acute kidney injury.
Article in Critical care (London, England), 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 79 papers, 8 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
79 citing papers in PubMed, 8 syntheses or guidelines pooled it, 228 citations in OpenAlex.
- Lower versus standard dose-intensity continuous renal replacement therapy: a systematic review and meta-analysis.Critical care (London, England) · 2026Pooled it
- A Systematic Bibliometric Analysis of High-Impact Articles in Critical Care Nephrology.Blood purification · 2024Pooled it
- Non-pharmacological interventions for preventing clotting of extracorporeal circuits during continuous renal replacement therapy.The Cochrane database of systematic reviews · 2021Pooled it
- Pharmacological interventions for preventing clotting of extracorporeal circuits during continuous renal replacement therapy.The Cochrane database of systematic reviews · 2020Pooled it
- Pharmacological interventions for preventing clotting of extracorporeal circuits during continuous renal replacement therapy.The Cochrane database of systematic reviews · 2020Pooled it
- Effect of high-volume hemofiltration on mortality in critically ill patients: A PRISMA-compliant systematic review and meta-analysis.Medicine · 2018Pooled it
- Pooled it
- Intensity of continuous renal replacement therapy for acute kidney injury.The Cochrane database of systematic reviews · 2016Pooled it
- The effect of continuous versus intermittent renal replacement therapy on the outcome of critically ill patients with acute renal failure (CONVINT): a prospective randomized controlled trial.Critical care (London, England) · 2014Trial
- High-volume versus standard-volume haemofiltration for septic shock patients with acute kidney injury (IVOIRE study): a multicentre randomized controlled trial.Intensive care medicine · 2013Trial
- Early acid-base and blood pressure effects of continuous renal replacement therapy intensity in patients with metabolic acidosis.Intensive care medicine · 2013Trial
- Sustained low efficiency dialysis using a single-pass batch system in acute kidney injury - a randomized interventional trial: the REnal Replacement Therapy Study in Intensive Care Unit PatiEnts.Critical care (London, England) · 2012Trial
- Solute clearance in CRRT: prescribed dose versus actual delivered dose.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2012Trial
- Association between obesity and kidney outcomes in critically ill patients with acute kidney injury receiving continuous renal replacement therapy: a secondary analysis of the multicenter CRRTnet study.Critical care (London, England) · 2026Observational
- Korean Society of Nephrology 2025 Evidence-Based Clinical Practice Guideline for Continuous Kidney Replacement Therapy.Electrolyte & blood pressure : E & BP · 2026Review
- Korean Society of Nephrology 2025 evidence-based clinical practice guideline for continuous kidney replacement therapy.Kidney research and clinical practice · 2026Article
- Article
- Programs and processes for advancing pediatric acute kidney support therapy in hospitalized and critically ill children: a report from the 26th Acute Disease Quality Initiative (ADQI) consensus conference.Pediatric nephrology (Berlin, Germany) · 2024Article
- Continuous Renal Replacement Therapy and Mortality in Critically Ill Obese Adults.Critical care explorations · 2023Article
- Extracorporeal blood purification therapies for sepsis-associated acute kidney injury in critically ill patients: expert opinion from the SIAARTI-SIN joint commission.Journal of nephrology · 2023Article
19 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
13 authors at 11 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe optimal dialysis dose for the treatment of acute kidney injury (AKI) is controversial. We sought to evaluate the relationship between renal replacement therapy (RRT) dose and outcome.
methodsWe performed a prospective multicentre observational study in 30 intensive care units (ICUs) in eight countries from June 2005 to December 2007. Delivered RRT dose was calculated in patients treated exclusively with either continuous RRT (CRRT) or intermittent RRT (IRRT) during their ICU stay. Dose was categorised into more-intensive (CRRT >or= 35 ml/kg/hour, IRRT >or= 6 sessions/week) or less-intensive (CRRT < 35 ml/kg/hour, IRRT < 6 sessions/week). The main outcome measures were ICU mortality, ICU length of stay and duration of mechanical ventilation.
resultsOf 15,200 critically ill patients admitted during the study period, 553 AKI patients were treated with RRT, including 338 who received CRRT only and 87 who received IRRT only. For CRRT, the median delivered dose was 27.1 ml/kg/hour (interquartile range (IQR) = 22.1 to 33.9). For IRRT, the median dose was 7 sessions/week (IQR = 5 to 7). Only 22% of CRRT patients and 64% of IRRT patients received a more-intensive dose. Crude ICU mortality among CRRT patients were 60.8% vs. 52.5% (more-intensive vs. less-intensive groups, respectively). In IRRT, this was 23.6 vs. 19.4%, respectively. On multivariable analysis, there was no significant association between RRT dose and ICU mortality (Odds ratio (OR) more-intensive vs. less-intensive: CRRT OR = 1.21, 95% confidence interval (CI) = 0.66 to 2.21; IRRT OR = 1.50, 95% CI = 0.48 to 4.67). Among survivors, shorter ICU stay and duration of mechanical ventilation were observed in the more-intensive RRT groups (more-intensive vs. less-intensive for all: CRRT (median): 15 (IQR = 8 to 26) vs. 19.5 (IQR = 12 to 33.5) ICU days, P = 0.063; 7 (IQR = 4 to 17) vs. 14 (IQR = 5 to 24) ventilation days, P = 0.031; IRRT: 8 (IQR = 5.5 to 14) vs. 18 (IQR = 13 to 35) ICU days, P = 0.008; 2.5 (IQR = 0 to 10) vs. 12 (IQR = 3 to 24) ventilation days, P = 0.026).
conclusionsAfter adjustment for multiple variables, these data provide no evidence for a survival benefit afforded by higher dose RRT. However, more-intensive RRT was associated with a favourable effect on ICU stay and duration of mechanical ventilation among survivors. This result warrants further exploration.
trial registrationCochrane Renal Group (CRG110600093).
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.