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Renal - Renal Replacement Therapy

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Outcomes in Patients with Vasodilatory Shock and Renal Replacement Therapy Treated with Intravenous Angiotensin II.
Tumlin JA, Murugan R, Deane AM, Ostermann M, Busse LW, Ham KR, Kashani K, Szerlip HM, Prowle JR, Bihorac A, Finkel KW, Zarbock A, Forni LG, Lynch SJ, Jensen J, Kroll S, Chawla LS, Tidmarsh GF, Bellomo R; Angiotensin II for the Treatment of High-Output Shock 3 (ATHOS-3) Investigators.
Crit Care Med. 2018 Jun;46(6):949-957

Rationale for inclusion: RCT with Angiotensin II vs placebo. 105 pts. With higher survival in treatment group.

CAVEAT: Small numbers but significant result

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Regional citrate versus heparin anticoagulation for continuous renal replacement therapy: a meta-analysis of randomized controlled trials.
Wu MY, Hsu YH, Bai CH, Lin YF, Wu CH, Tam KW.
Am J Kidney Dis. 2012 Jun;59(6):810-8.

Rationale for inclusion: Citrate is associated with decreased bleeding in patients requiring CRRT.

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Timing of renal replacement therapy and clinical outcomes in critically ill patients with severe acute kidney injury.
Bagshaw SM, Uchino S, Bellomo R, Morimatsu H, Morgera S, Schetz M, Tan I, Bouman C, Macedo E, Gibney N, Tolwani A, Oudemans-van Straaten HM, Ronco C, Kellum JA; Beginning and Ending Supportive Therapy for the Kidney (BEST Kidney) Investigators.
J Crit Care. 2009 Mar;24(1):129-40.

Rationale for inclusion: Delayed initiation of RRT is associated with increased mortality, longer duration of RRT, LOS and dialysis dependence.

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Intermittent versus continuous renal replacement therapy for acute kidney injury patients admitted to the intensive care unit: results of a randomized clinical trial.
Lins RL, Elseviers MM, Van der Niepen P, Hoste E, Malbrain ML, Damas P, Devriendt J; SHARF investigators.
Nephrol Dial Transplant. 2009 Feb;24(2):512-8.

Rationale for inclusion: RCT: No difference in mortality between HD and CRR.

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Timing of renal replacement therapy initiation in acute renal failure: a meta-analysis.
Seabra VF, Balk EM, Liangos O, Sosa MA, Cendoroglo M, Jaber BL.
Am J Kidney Dis. 2008 Aug;52(2):272-84.

Rationale for inclusion: Meta-analysis: Improved survival in early RRT.

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Continuous renal replacement therapy is associated with less chronic renal failure than intermittent haemodialysis after acute renal failure.
Bell M; SWING, Granath F, Schön S, Ekbom A, Martling CR.
Intensive Care Med. 2007 May;33(5):773-80.

Rationale for inclusion: Improved renal recovery in CRRT compared to IHD. No difference in mortality.

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Continuous venovenous haemodiafiltration versus intermittent haemodialysis for acute renal failure in patients with multiple-organ dysfunction syndrome: a multicentre randomised trial.
Vinsonneau C, Camus C, Combes A, Costa de Beauregard MA, Klouche K, Boulain T, Pallot JL, Chiche JD, Taupin P, Landais P, Dhainaut JF; Hemodiafe Study Group.
Lancet. 2006 Jul 29;368(9533):379-85.

Rationale for inclusion: No difference in mortality between HD and CRRT in patients with MOF.

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Survival and quality of life of patients requiring acute renal replacement therapy.
Ahlström A, Tallgren M, Peltonen S, Räsänen P, Pettilä V.
Intensive Care Med. 2005 Sep;31(9):1222-8.

Rationale for inclusion: Long term outcomes in ICU patients with ARF.

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A randomized clinical trial of continuous versus intermittent dialysis for acute renal failure.
Mehta RL, McDonald B, Gabbai FB, Pahl M, Pascual MT, Farkas A, Kaplan RM; Collaborative Group for Treatment of ARF in the ICU.
Kidney Int. 2001 Sep;60(3):1154-63.

Rationale for inclusion: No difference in mortality between HD and CRRT.

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Effects of continuous haemofiltration vs intermittent haemodialysis on systemic haemodynamics and splanchnic regional perfusion in septic shock patients: a prospective, randomized clinical trial.
John S, Griesbach D, Baumgärtel M, Weihprecht H, Schmieder RE, Geiger H.
Nephrol Dial Transplant. 2001 Feb;16(2):320-7.

Rationale for inclusion: Better hemodynamics but no difference in organ perfusion with CVVH compared to IHD.

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Continuous veno-venous hemofiltration without anticoagulation in high-risk patients.
Tan HK, Baldwin I, Bellomo R.
Intensive Care Med. 2000 Nov;26(11):1652-7.

Rationale for inclusion: No need for anticoagulation on CRRT in high-risk patients.

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Effects of different doses in continuous veno-venous haemofiltration on outcomes of acute renal failure: a prospective randomised trial.
Ronco C, Bellomo R, Homel P, Brendolan A, Dan M, Piccinni P, La Greca G.
Lancet. 2000 Jul 1;356(9223):26-30.

Rationale for inclusion: Higher doses of CVVH were associated with improved early mortality.

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Improved cardiovascular stability during continuous modes of renal replacement therapy in critically ill patients with acute hepatic and renal failure.
Davenport A, Will EJ, Davidson AM.
Crit Care Med. 1993 Mar;21(3):328-38.

Rationale for inclusion: Improved hemodynamics tolerance in CRRT compared to IHD in patients with impaired oxygen delivery.

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