American journal of kidney diseases : the official journal of the National Kidney Foundation
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Review Meta Analysis Comparative Study
Acute renal failure in the intensive care unit: a systematic review of the impact of dialytic modality on mortality and renal recovery.
There is controversy about which dialytic modality should be used for the treatment of acute renal failure (ARF) in the intensive care unit. We performed a systematic review and meta-analysis to determine the relative risks (RRs) of mortality and renal recovery associated with intermittent hemodialysis (IHD) therapy compared with continuous renal replacement therapy (CRRT) in critically ill adults with ARF. ⋯ In comparison to IHD therapy, CRRT does not improve survival or renal recovery in unselected critically ill patients with ARF. Future studies should focus on well-defined subgroups of such patients using lessons learned from the trials in this meta-analysis. The high cost of chronic dialysis therapy and the relative instability of the RR for dialysis dependence suggest that future trials also should evaluate differences in renal recovery between dialytic modalities.