title: Continuous renal replacement therapy improves renal recovery from acute renal failure.
abstract: BACKGROUND
  Acute renal failure (ARF) occurs in up to 10% of critically ill patients, with significant associated morbidity and mortality. The optimal mode of renal replacement therapy (RRT) remains controversial. This retrospective study compared continuous renal replacement therapy (CRRT) and intermittent hemodialysis (IHD) for RRT in terms of intensive care unit (ICU) and hospital mortality, and renal recovery.
  
  
  METHODS
  We reviewed the records of all patients undergoing RRT for the treatment of ARF over a 12-month period. Patients were compared according to mode of RRT, demographics, physiologic characteristics, and outcomes of ICU and hospital mortality and renal recovery using the Chi square, Student's t test, and multiple logistic regression as appropriate.
  
  
  RESULTS
  116 patients with renal insufficiency underwent RRT during the study period. Of these, 93 had ARF. The severity of illness of CRRT patients was similar to that of IHD patients using APACHE II (25.1 vs 23.5, P = 0.37), but they required significantly more intensive nursing (therapeutic intervention scale 47.8 vs 37.6, P = 0.0001). Mortality was associated with lower pH at presentation (P = 0.003) and increasing age (P = 0.03). Renal recovery was significantly more frequent among patients initially treated with CRRT (21/24 vs 5/14, P = 0.0003). Further investigation to define optimal timing, dose, and duration of RRT may be beneficial.
  
  
  CONCLUSIONS
  Although further study is needed, this study suggests that renal recovery may be better after CRRT than IHD for ARF. Mortality was not affected significantly by RRT mode.
authors.affiliation: Department of Anesthesiology, University of Alberta Hospitals, 32B2.32 Walter C. Mackenzie Health Sciences Centre, Edmonton, Alberta T6G 2B7, Canada. mjacka@ualberta.ca
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Jacka
authors.forename: Xenia
authors.initials: X
authors.lastname: Ivancinova
authors.forename: R T Noel
authors.initials: RT
authors.lastname: Gibney
mesh_terms: D058186:Acute Kidney Injury / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D017582:Renal Replacement Therapy