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Continuous dialysis is superior to intermittent dialysis in acute kidney injury of the critically ill patient

Nature Clinical Practice Nephrology volume 3, pages 118–119 (2007)Cite this article

Acute kidney injury (AKI) affects 5–7% of hospitalized patients and continues to be associated with poor outcomes despite technological advances.1 Patients who would previously have died from other causes now survive long enough to develop AKI and complex physiological derangements, which are associated with high mortality. AKI is frequent in the intensive care unit (ICU); the reported incidence is 1–25%2 depending on the population studied and the definition used. Thus, we observe two separate syndromes. Uncomplicated AKI can be managed outside the ICU and usually carries a good prognosis (disease-related mortality <10%). By contrast, complicated AKI in the ICU develops as part of multiple organ dysfunction syndrome and is associated with 50–70% mortality during the ICU stay.3 The average outcome of these two syndromes has caused AKI mortality rates to falsely appear constant over the past few decades.

Increasing complexity of patients in ICUs has led to continuous renal replacement therapy (CRRT) techniques being developed. Continuous arteriovenous hemofiltration was safe and well tolerated but lacked efficiency. Machines introduced subsequently have made it possible to perform continuous venovenous hemofiltration with hemodialysis and hemodiafiltration, thus maintaining good clinical tolerability but allowing adequate blood purification.4

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  1. Department of Nephrology, San Bortolo Hospital, Viale Rodolfi 37, 36100 Vicenza, Italy claudio.ronco@ulssvicenza.it

Authors and Affiliations

  1. C Ronco is Head of the Department of Nephrology, Dialysis and Transplantation at San Bortolo Hospital, Vicenza, Italy.,

    Claudio Ronco

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  1. Claudio Ronco
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Ronco, C. Continuous dialysis is superior to intermittent dialysis in acute kidney injury of the critically ill patient. Nat Rev Nephrol 3, 118–119 (2007). https://doi.org/10.1038/ncpneph0423

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