High versus low intensity renal replacement therapy

What’s the optimal dose of continuous renal replacement therapy? The Australasian RENAL investigators compared 25ml/kg/hr vs 40ml/kg/hr (effluent flow) of post-dilution continuous venovenous haemodiafiltration in over 1500 intensive care patients. There was no difference in 90 day mortality or renal recovery, but the high intensity group had significantly more hypophosphataemia.
Intensity of Continuous Renal-Replacement Therapy in Critically Ill Patients
NEJM 2009;361:1627-1638

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