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Pro/con debate: continuous versus intermittent dialysis for acute kidney injury: a never-ending story yet approaching the finish?

Raymond Vanholder UGent, Wim Van Biesen UGent, Eric Hoste UGent and Norbert Lameire (2011) CRITICAL CARE. 15(1).
abstract
The question of whether renal replacement therapy should be applied in an intermittent or continuous mode to the patient with acute kidney injury has been the topic of several controlled studies and meta-analyses. Although continuous renal replacement therapy (CRRT) has a theoretical advantage due to offering the opportunity to remove excess fluid more gradually, none of the several outcome studies that have been undertaken in the meanwhile was able to demonstrate its superiority over intermittent renal replacement therapy (IRRT). In the present article, therefore, questions are raised regarding which are the specific advantages of each strategy, and which are the specific populations that might benefit from their application. Although several advantages have been attributed to CRRT - especially more hemodynamic stability allowing more adequate fluid removal, better recovery of renal function, and more efficient removal of small and large metabolites - none of these could be adequately proven in controlled trials. CRRT is claimed to be better tolerated in combined acute liver and kidney failure and in acute brain injury. IRRT is more practical, flexible and cost-effective, allows the clinician to discontinue or to minimize anticoagulation with bleeding risks, and removes small solutes such as potassium more efficiently in acute life-threatening conditions. Sustained low-efficiency daily dialysis is a hybrid therapy combining most of the advantages of both options.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (review)
publication status
published
subject
keyword
INTENSIVE-CARE-UNIT, EXTENDED DAILY DIALYSIS, CRITICALLY-ILL PATIENTS, ACUTE-RENAL-FAILURE, CONTINUOUS VENOVENOUS HEMOFILTRATION, RANDOMIZED CLINICAL-TRIAL, CONTINUOUS ARTERIOVENOUS HEMOFILTRATION, ORGAN DYSFUNCTION SYNDROME, REPLACEMENT THERAPY, CITRATE ANTICOAGULATION
journal title
CRITICAL CARE
Crit. Care
volume
15
issue
1
article number
204
pages
7 pages
Web of Science type
Review
Web of Science id
000288961900104
JCR category
CRITICAL CARE MEDICINE
JCR impact factor
4.607 (2011)
JCR rank
5/26 (2011)
JCR quartile
1 (2011)
ISSN
1466-609X
DOI
10.1186/cc9345
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
1268872
handle
http://hdl.handle.net/1854/LU-1268872
date created
2011-06-20 14:57:13
date last changed
2016-12-21 15:41:55
@article{1268872,
  abstract     = {The question of whether renal replacement therapy should be applied in an intermittent or continuous mode to the patient with acute kidney injury has been the topic of several controlled studies and meta-analyses. Although continuous renal replacement therapy (CRRT) has a theoretical advantage due to offering the opportunity to remove excess fluid more gradually, none of the several outcome studies that have been undertaken in the meanwhile was able to demonstrate its superiority over intermittent renal replacement therapy (IRRT). In the present article, therefore, questions are raised regarding which are the specific advantages of each strategy, and which are the specific populations that might benefit from their application. Although several advantages have been attributed to CRRT - especially more hemodynamic stability allowing more adequate fluid removal, better recovery of renal function, and more efficient removal of small and large metabolites - none of these could be adequately proven in controlled trials. CRRT is claimed to be better tolerated in combined acute liver and kidney failure and in acute brain injury. IRRT is more practical, flexible and cost-effective, allows the clinician to discontinue or to minimize anticoagulation with bleeding risks, and removes small solutes such as potassium more efficiently in acute life-threatening conditions. Sustained low-efficiency daily dialysis is a hybrid therapy combining most of the advantages of both options.},
  articleno    = {204},
  author       = {Vanholder, Raymond and Van Biesen, Wim and Hoste, Eric and Lameire, Norbert},
  issn         = {1466-609X},
  journal      = {CRITICAL CARE},
  keyword      = {INTENSIVE-CARE-UNIT,EXTENDED DAILY DIALYSIS,CRITICALLY-ILL PATIENTS,ACUTE-RENAL-FAILURE,CONTINUOUS VENOVENOUS HEMOFILTRATION,RANDOMIZED CLINICAL-TRIAL,CONTINUOUS ARTERIOVENOUS HEMOFILTRATION,ORGAN DYSFUNCTION SYNDROME,REPLACEMENT THERAPY,CITRATE ANTICOAGULATION},
  language     = {eng},
  number       = {1},
  pages        = {7},
  title        = {Pro/con debate: continuous versus intermittent dialysis for acute kidney injury: a never-ending story yet approaching the finish?},
  url          = {http://dx.doi.org/10.1186/cc9345},
  volume       = {15},
  year         = {2011},
}

Chicago
Vanholder, Raymond, Wim Van Biesen, Eric Hoste, and Norbert Lameire. 2011. “Pro/con Debate: Continuous Versus Intermittent Dialysis for Acute Kidney Injury: a Never-ending Story yet Approaching the Finish?” Critical Care 15 (1).
APA
Vanholder, R., Van Biesen, W., Hoste, E., & Lameire, N. (2011). Pro/con debate: continuous versus intermittent dialysis for acute kidney injury: a never-ending story yet approaching the finish? CRITICAL CARE, 15(1).
Vancouver
1.
Vanholder R, Van Biesen W, Hoste E, Lameire N. Pro/con debate: continuous versus intermittent dialysis for acute kidney injury: a never-ending story yet approaching the finish? CRITICAL CARE. 2011;15(1).
MLA
Vanholder, Raymond, Wim Van Biesen, Eric Hoste, et al. “Pro/con Debate: Continuous Versus Intermittent Dialysis for Acute Kidney Injury: a Never-ending Story yet Approaching the Finish?” CRITICAL CARE 15.1 (2011): n. pag. Print.