Dialysis dose in acute kidney injury: no time for therapeutic nihilism – a critical appraisal of the Acute Renal Failure Trial Network study
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* Corresponding author: Claudio Ronco Cronco@goldnet.it
1 Nephrology Department, St Bortolo Hospital, Viale Rodolfi 37, 36100 Vicenza, Italy
2 International Renal Research Institute Vicenza (IRRIV), Viale Rodolfi 37, 36100 Vicenza, Italy
3 Department of Intensive Care, Onze Lieve Vrouwe Gasthuis, Oosterpark 9, 1091 AC Amsterdam, the Netherlands
4 Intensive Care Unit, St-Pierre Para-Universitary Hospital, 9 Avenue Reine Fabiola, 1340 Ottignies-Louvain-la-Neuve, Belgium
5 London Health Sciences Centre, 339 Windermere Road, London, Ontario, Canada N6A 5A5
6 Medical Intensive Care Unit, Peking Union Medical College Hospital, Shuaifuyuan 1, Wangfujing, Beijing, 100730, PR China
7 Division of Critical Care Medicine, University of Alberta, 3C1.12 Walter C. Mackenzie Centre, 8440-112 Street, Edmonton, Alberta T6G 2B7, Canada
Critical Care 2008, 12:308 doi:10.1186/cc7016
Published: 16 October 2008Abstract
The optimal dialysis dose for acute kidney injury is a matter of great controversy. Clinical trials, predominantly single-center studies, have shown conflicting results. The Acute Renal Failure Trial Network (ATN) Study was designed to compare clinical outcomes between patients allocated to an intensive dose versus a less-intensive dose of renal replacement therapy. Recently, the results of this large randomized controlled multicenter study were published. The present article will discuss certain aspects of this trial: the overall design, the baseline patient characteristics, and comparison of the results with earlier studies. Finally, the article will address the implications of the ATN Study results for clinical practice.