title: Sustained low efficiency dialysis using a single-pass batch system in acute kidney injury - a randomized interventional trial: the REnal Replacement Therapy Study in Intensive Care Unit PatiEnts.
abstract: BACKGROUND
  Acute kidney injury (AKI) is associated with a high mortality of up to 60%. The mode of renal replacement therapy (intermittent versus continuous) has no impact on patient survival. Sustained low efficiency dialysis using a single-pass batch dialysis system (SLED-BD) has recently been introduced for the treatment of dialysis-dependent AKI. To date, however, only limited evidence is available in the comparison of SLED-BD versus continuous veno-venous hemofiltration (CVVH) in intensive care unit (ICU) patients with AKI.
  
  
  METHODS
  Prospective, randomized, interventional, clinical study at a surgical intensive care unit of a university hospital. Between 1 April 2006 and 31 January 2009, 232 AKI patients who underwent renal replacement therapy (RRT) were randomized in the study. Follow-up was assessed until 30 August 2009. Patients were either assigned to 12-h SLED-BD or to 24-h predilutional CVVH. Both therapies were performed at a blood flow of 100 to 120 ml/min.
  
  
  RESULTS
  115 patients were treated with SLED-BD (total number of treatments n = 817) and 117 patients with CVVH (total number of treatments n = 877).The primary outcome measure, 90-day mortality, was similar between groups (SLED: 49.6% vs. CVVH: 55.6%, P = 0.43). Hemodynamic stability did not differ between SLED-BD and CVVH, whereas patients in the SLED-BD group had significantly fewer days of mechanical ventilation (17.7 ± 19.4 vs. 20.9 ± 19.8, P = 0.047) and fewer days in the ICU (19.6 ± 20.1 vs. 23.7 ± 21.9, P = 0.04). Patients treated with SLED needed fewer blood transfusions (1,375 ± 2,573 ml vs. 1,976 ± 3,316 ml, P = 0.02) and had a substantial reduction in nursing time spent for renal replacement therapy (P < 0.001) resulting in lower costs.
  
  
  CONCLUSIONS
  SLED-BD was associated with reduced nursing time and lower costs compared to CVVH at similar outcomes. In the light of limited health care resources, SLED-BD offers an attractive alternative for the treatment of AKI in ICU patients.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT00322530.
authors: Vedat
authors: V
authors: Schwenger
authors: Markus A
authors: MA
authors: Weigand
authors: Oskar
authors: O
authors: Hoffmann
authors: Ralf
authors: R
authors: Dikow
authors: Lars P
authors: LP
authors: Kihm
authors: Jörg
authors: J
authors: Seckinger
authors: Nexhat
authors: N
authors: Miftari
authors: Matthias
authors: M
authors: Schaier
authors: Stefan
authors: S
authors: Hofer
authors: Caroline
authors: C
authors: Haar
authors: Peter P
authors: PP
authors: Nawroth
authors: Martin
authors: M
authors: Zeier
authors: Eike
authors: E
authors: Martin
authors: Christian
authors: C
authors: Morath
mesh_terms: D058186:Acute Kidney Injury / Q000401:mortality / Q000628:therapy*; D000368:Aged; D005260:Female; D006440:Hemofiltration; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D011446:Prospective Studies; D006435:Renal Dialysis / Q000191:economics / Q000379:methods*; D015996:Survival Rate; D016896:Treatment Outcome