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Continuous dialysis is not superior to intermittent dialysis in acute kidney injury of the critically ill patient

Nature Clinical Practice Nephrology volume 3, pages 120–121 (2007)Cite this article

New methods of cures always work miracles for a while. (William Heberden, 1710–1801)

Kramer and colleagues pioneered the concept of continuous renal replacement therapy (CRRT) in the intensive care unit (ICU) in 1977.1 CRRT was introduced after it was commonly observed that intermittent hemodialysis (IHD) frequently worsened hemodynamics in critically ill patients, who were often hypotensive, in shock, and on pressor support.2 CRRT offered continuous regulation of volume and solute homeostasis, which promised greater hemodynamic and metabolic stability.3 In the ensuing three decades, many clinicians and investigators caring for critically ill patients with severe acute kidney injury (AKI) have continued to regard CRRT as an inherently superior therapy, and thus the treatment of choice in the ICU. Indeed, in a recent international epidemiologic survey, more than 80% of patients with AKI who were critically ill received CRRT, compared with only 17% who received IHD.4

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  1. Maine Medical Center, 22 Bramhall Street, Portland, ME 04102, USA himmej@mmc.org

Authors and Affiliations

  1. J Himmelfarb is Director of the Division of Nephrology and Transplantation at Maine Medical Center, Portland, ME, USA.,

    Jonathan Himmelfarb

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  1. Jonathan Himmelfarb
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Himmelfarb, J. Continuous dialysis is not superior to intermittent dialysis in acute kidney injury of the critically ill patient. Nat Rev Nephrol 3, 120–121 (2007). https://doi.org/10.1038/ncpneph0422

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