Critical Care Medicine-Renal, Electrolyte and Acid Base Disorders>>>>>Renal Replacement Therapy
Question 9#

What is the recommended delivered dose of the effluent in CRRT?

A. 10 to 20 mL/kg/h
B. 20 to 25 mL/kg/h
C. 30 to 40 mL/kg/h
D. 50 to 60 mL/kg/h

Correct Answer is B

Comment:

Correct Answer: B

Two large randomized controlled trials found no significant difference in mortality with effluent doses above 20 to 25 mL/kg/h. There were no significant differences in the secondary outcomes such as renal recovery and nonrenal organ failure as well. Of note, there were a few serious adverse events in the higher-intensity group. The KDIGO clinical practice guidelines recommend delivering an effluent dose of 20 to 25 mL/kg/h for CRRT in patients with AKI. Higher effluent rates confer no mortality benefit compared to a rate 20 to 25 mL/kg/h.

References:

1. Palevsky PM, Zhang JH, O’Connor TZ, Chertow GM, Crowley ST, Choudhury D, et al. Intensity of renal support in critically ill patients with acute kidney injury. N Engl J Med. 2008;359:7-20.
2. Investigators, The RENAL replacement therapy study. Intensity of continuous renal-replacement therapy in critically ill patients. N Engl J Med. 2009;361:1627-1638.