ArticleMedical principles and practice : international journal of the Kuwait University, Health Science Centre2026
Sustained Low-Efficiency Dialysis versus Intermittent Hemodialysis in Critically Ill Patients with Severe Acute Kidney Injury.
Article in Medical principles and practice : international journal of the Kuwait University, Health Science Centre, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveThe objectives of the study were to compare clinical efficacy, hemodynamic stability, and 90-day renal outcomes between sustained low-efficiency dialysis (SLED) and intermittent hemodialysis (IHD) in medical intensive care unit (MICU) patients with severe acute kidney injury (AKI).
methodsThis observational cohort study evaluated 300 patients with KDIGO Stage-2 or 3 AKI (SLED: n = 160; IHD: n = 140). Outcomes included MICU mortality, discharge renal recovery, stay duration, intradialytic complications, and 90-day renal preservation.
resultsBaseline characteristics were comparable. No significant differences emerged between SLED and IHD regarding MICU mortality (33% vs. 39%, p = 0.272) or renal recovery at discharge (61% vs. 54%, p = 0.223). However, SLED demonstrated superior safety, significantly lowering intradialytic hypotension (21% vs. 41%, p < 0.001) and the need for new vasopressors (11% vs. 22%, p = 0.011), while minimizing mean arterial pressure drops (12.12 ± 3.9 vs. 19 ± 6.36 mm Hg, p < 0.001). SLED achieved shorter median MICU stays (14 vs. 16 days, p < 0.001). At 90-day, SLED survivors exhibited significantly lower renal replacement therapy dependence (11% vs. 24%, p = 0.014), reduced chronic kidney disease progression (26% vs. 34%, p = 0.044), and higher glomerular filtration rate (55.93 ± 7.69 vs. 45.86 ± 9.29 mL/min/1.73 m2, p < 0.001).
conclusionsWhile short-term mortality is similar, SLED dramatically mitigates intradialytic hemodynamic instability compared to IHD. By minimizing circulatory insults, SLED significantly improves 90-day parenchymal renal recovery and minimizes long-term dialysis dependence among AKI survivors.
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