ArticleCritical care (London, England)2014
The lower limit of intensity to control uremia during continuous renal replacement therapy.
Article in Critical care (London, England), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.
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Who cites it
11 citing papers in PubMed, 2 syntheses or guidelines pooled it, 20 citations in OpenAlex.
- Lower versus standard dose-intensity continuous renal replacement therapy: a systematic review and meta-analysis.Critical care (London, England) · 2026Pooled it
- [S3 guideline on renal replacement therapy in intensive care medicine : Evidence-based implementation of renal replacement therapy in critically ill patients].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2025Guideline
- Balancing carbon reduction and treatment adequacy in sustainable continuous renal replacement therapy.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2026Article
- Multidisciplinary guidelines on renal replacement therapy in intensive care medicine.Critical care (London, England) · 2026Review
- Comment on "The Critical Omission of CRRT Dose in Comparative Studies of RRT Modalities for Sepsis-Associated AKI".JA clinical reports · 2025Article
- The Urea-Creatinine Ratio as Marker of Catabolism Is Affected by Continuous Renal Replacement Therapy.Diagnostics (Basel, Switzerland) · 2025Article
- Intensive care unit continuous kidney replacement therapy: time to change dosage recommendations?International urology and nephrology · 2025Review
- Combination of Multiple Hemodialysis Modes: Better Treatment Options for Patients Under Maintenance Hemodialysis.Therapeutics and clinical risk management · 2021Article
- Ensuring Sustainability of Continuous Kidney Replacement Therapy in the Face of Extraordinary Demand: Lessons From the COVID-19 Pandemic.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2020Article
- Effect of blood purification on serum miR-126 and VEGF levels in the process of atherosclerosis in uremic patients under maintenance hemodialysis.The Kaohsiung journal of medical sciences · 2018Article
- Evaluation of CRRT effects on pyemic secondary AKI by serum cartilage glycoprotein 39 and Annexin A1.Experimental and therapeutic medicine · 2016Article
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Authors and funding
13 authors at 11 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe recommended lower limit of intensity during continuous renal replacement therapy (CRRT) is 20 or 25 mL/kg/h. However, limited information is available to support this threshold. We aimed to evaluate the impact of different intensities of CRRT on the clearance of creatinine and urea in critically ill patients with severe acute kidney injury (AKI).
methodsThis is a multicenter retrospective study conducted in 14 Japanese ICUs in 12 centers. All patients older than 18 years and treated with CRRT due to AKI were eligible. We evaluated the effect of CRRT intensity by two different definitions: daily intensity (the mean intensity over each 24-h period) and average intensity (the mean of daily intensity during the period while CRRT was performed). To study the effect of different CRRT intensity on clearance of urea and creatinine, all patients/daily observations were arbitrarily allocated to one of 4 groups based on the average intensity and daily intensity: <10, 10-15, 15-20, and >20 mL/kg/h.
resultsTotal 316 patients were included and divided into the four groups according to average CRRT intensity. The groups comprised 64 (20.3%), 138 (43.7%), 68 (21.5%), and 46 patients (14.6%), respectively. Decreases in creatinine and urea increased as the average intensity increased over the first 7 days of CRRT. The relative changes of serum creatinine and urea levels remained close to 1 over the 7 days in the "<10" group. Total 1,101 daily observations were included and divided into the four groups according to daily CRRT intensity. The groups comprised 254 (23.1%), 470 (42.7%), 239 (21.7%), and 138 observations (12.5%), respectively. Creatinine and urea increased (negative daily change) only in the "<10" group and decreased with the increasing daily intensity in the other groups.
conclusionsThe lower limit of delivered intensity to control uremia during CRRT was approximately between 10 and 15 mL/kg/h in our cohort. A prescribed intensity of approximately 15 mL/kg/h might be adequate to control uremia for patients with severe AKI in the ICU. However, considering the limitations due to the retrospective nature of this study, prospective studies are required to confirm our findings.
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