Intermittent or Continuous Renal-Replacement Therapy in Acute Kidney Injury.

Intermittent hemodialysis is associated with higher 90-day mortality than continuous renal-replacement therapy in critically ill patients with acute kidney injury.

• Why it matters: Determining the optimal renal-replacement therapy method is crucial for improving survival and outcomes in critically ill patients with acute kidney injury, yet the preferred approach remains uncertain.
• What they did: In a multicenter, open-label, noninferiority trial, 554 critically ill adults requiring renal-replacement therapy were randomly assigned to undergo either intermittent hemodialysis or continuous renal-replacement therapy, with primary outcomes assessed at 90 days.
• The result: The trial was stopped early due to higher mortality observed with intermittent hemodialysis, with 63.1% versus 53.5% mortality in the two groups, and a 6.28 percentage point higher risk of major adverse kidney events in the intermittent group.