The first international consensus conference on continuous renal replacement therapy.
BACKGROUND
Management of acute renal failure (ARF) in the critically ill is extremely variable and there are no published standards for the provision of renal replacement therapy in this population. We sought to review the available evidence, make evidence-based practice recommendations, and delineate key questions for future study.


METHODS
We undertook an evidence-based review of the literature on continuous renal replacement therapy (CRRT) using MEDLINE searches. We determined a list of key questions and convened a 2-day consensus conference to develop summary statements via a series of alternating breakout and plenary sessions. In these sessions, we identified supporting evidence and generated practice guidelines and/or directions for future research.


RESULTS
Of the 46 questions considered, we found consensus for 20. We found inadequate evidence for 21 questions and for the remaining five we found data but no consensus. Full versions of workgroup findings are available on the Internet at http://www.ADQI.net.


CONCLUSIONS
Despite limited data, broad areas of consensus exist for use of CRRT and guideline development appears feasible. Equally broad areas of disagreement also exist and additional basic and applied research in acute renal failure is needed.
Kellum
John A
JA
Department of Critical Care Medicine and Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA. kellumja@anes.upmc.edu
Mehta
Ravindra L
RL
Angus
Derek C
DC
Palevsky
Paul
P
Ronco
Claudio
C
D058186:Acute Kidney Injury / Q000628:therapy*; D006801:Humans; D017410:Practice Guidelines as Topic; D017582:Renal Replacement Therapy / Q000379:methods*