Intensive renal replacement therapy (RRT) in critically ill patients with acute kidney injury does not improve outcomes, according to researchers.


The finding comes from a study of 1,124 such patients randomly assigned to receive either intensive RRT (563 patients) or less-intensive RRT (561 patients). All patients had failure of at least one nonrenal organ or sepsis.

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By day 60, the rate of death from any cause was 53.6% among those receiving intensive treatment and 51.5% of those in the less-intensive treatment arm, a nonsignificant difference between groups, according to a report in the New England Journal of Medicine (2008; published online ahead of print). The investigators observed no significant difference in duration of RRT or rate of recovery of renal function or nonrenal organ failure.


In addition, in-hospital mortality through day 60 was 51.2% and 48% in the intensive-therapy and less-intensive therapy groups, respectively, researchers noted.