Evidence map›Paper›PMID 42857206›Full record

ArticleCritical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine2026

Low-intensity versus medium-intensity continuous renal replacement therapy for critically ill patients (LIMIT) trial: Protocol summary and statistical analysis plan of a randomised clinical trial.

Tomoko Fujii, Yu Amemiya, Akira Endo, Naoya Iguchi, Hisashi Imahase, Yu Kawazoe, Kyohei Miyamoto, Hiraaki Okuzawa, Aiko Tanaka, Ryo Yamamoto and 4 more

Abstract read
In one paragraph

Article in Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Tomoko FujiiDepartment of Intensive Care, Jikei University Hospital, Tokyo, Japan.
Yu AmemiyaDepartment of Emergency and Critical Care Medicine, Osaka Medical and Pharmaceutical University, Osaka, Japan.
Akira EndoDepartment of Anesthesiology and Critical Care Medicine, Division of Acute and Critical Care Medicine, Hokkaido University Faculty of Medicine, Hokkaido, Japan.
Naoya IguchiDepartment of Anesthesiology and Intensive Care Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
Hisashi ImahaseDivision of Intensive Care, Department of Anesthesiology and Intensive Care Medicine, Jichi Medical University School of Medicine, Tochigi, Japan.
Yu KawazoeDepartment of Emergency and Critical Care Medicine, National Hospital Organization Sendai Medical Center, Miyagi, Japan.
Kyohei MiyamotoDepartment of Emergency and Critical Care Medicine, Wakayama Medical University, Wakayama, Japan.
Hiraaki OkuzawaDepartment of Acute Critical Care Medicine, Tsuchiura Kyodo General Hospital, Ibaraki, Japan.
Aiko TanakaDepartment of Anesthesiology and Intensive Care Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
Ryo YamamotoDepartment of Emergency and Critical Care Medicine, Keio University School of Medicine, Tokyo, Japan.
Makoto ChidaResearch Promotion Center, The Jikei University School of Medicine, Tokyo, Japan.
Megumi FurukawaResearch Promotion Center, The Jikei University School of Medicine, Tokyo, Japan.
Shiro TanakaCenter for Clinical and Translational Research, Kyushu University Hospital, Fukuoka, Japan.
LIMIT trial investigators

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Severe acute kidney injury in critically ill patients may require continuous renal replacement therapy (CRRT), yet mortality remains high. A standard CRRT intensity is 20-25 mL/kg/hr, because higher doses have not improved outcomes. Excessive treatment may cause harm by removing antibiotics and other essential substances and potentially impairing renal recovery. Observational data suggest that lower-intensity CRRT may be effective, warranting a clinical trial to compare low-versus standard-intensity therapy. Objective: The objective of this study was to describe the prespecified protocol and the statistical analysis plan of the low-intensity versus medium-intensity continuous renal replacement therapy for critically Ill patients (LIMIT) trial. Design Setting Participants and Interventions: The LIMIT trial is an investigator-initiated, multicentre, open-label, randomised clinical trial, with a target sample size of 400 participants. The trial compares low-intensity CRRT (12 mL/kg/hr) and medium-intensity CRRT (25 mL/kg/hr) in adult patients with acute kidney injury requiring CRRT in the participating intensive care units. Main outcome measures: The primary outcome is a hierarchical composite of survival and time to successful liberation from RRT through day 28 from randomisation, analysed using a win-ratio. Secondary outcomes include intensive care unit mortality, hospital mortality, dialysis dependence at hospital discharge among survivors, vasopressor-free days at day 28, and ventilator-free days at day 28. Conclusion: The LIMIT trial will evaluate the effect of low-intensity CRRT on mortality and time to successful liberation from RRT compared with medium-intensity CRRT in adults with acute kidney injury. Its findings may also inform future research on broader patient-centred and societal implications of CRRT intensity.

Indexed as

Acute kidney injuryProtocolRandomised clinical trialRenal replacement therapyTreatment intensity

Identifiers

PMID42857206
PMCPMC13651648

What OpenQuestion holds

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Registered trials

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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.