Continuous renal replacement therapy versus intermittent haemodialysis: Impact on clinical outcomes

Abstract

Based on evidence from seminal randomised controlled trials, consensus reports conclude that continuous renal replacement therapy (CRRT) offers no survival benefit over intermittent haemodialysis (IHD) in critically ill patients with acute kidney injury (AKI). In contrast, emerging evidence from observational studies shows higher rates of end-stage kidney disease in IHD-treated patients, a complication likely related to hypotensive episodes during IHD. CRRT should hence be the first choice in haemodynamically unstable patients. AKI patients recovering from critical illness and discharged from intensive care unit (ICU) will continue to require IHD since this technique enables more effective mobilisation and CRRT cannot be safely conducted outside the ICU.