Acute renal failure is a frequent complication in critically ill patients that carries with it considerable morbidity and mortality. The management of renal failure in patients with multi-organ failure is different from that of renal failure that presents as a single organ failure. Intermittent haemodialysis, done in the conventional manner may not be tolerated by most critically ill patients. Continuous renal replacement therapy is physiologically superior; however, there is lack of strong evidence to prove a clinical benefit. Hybrid therapies that combine the benefits of intermittent haemodialysis and continuous therapies have emerged in the past few years. These are simpler to carry out, provide more flexibility and may be cost effective and need to be studied in a systematic manner.
Acute renal failure and sepsis. N Engl J Med 2004;351:159-69.
The effect of acute renal failure on mortality: A cohort analysis. JAMA 1996;275:1489-94.
German Competence Network Sepsis (Sepnet): Acute renal failure in patients with severe sepsis and septic shock: A significant independent risk factor for mortality: Results from the German Prevalence Study. Nephrol Dial Transplant 2008;23:904-9.
Daily hemodialysis and the outcome of acute renal failure. N Engl J Med 2002;346:305-10.
Effects of different doses in continuous venovenous haemofiltration on outcomes of acute renal failure: A prospective randomised trial. Lancet 2000;356:26-30.
VA/NIH Acute Renal Failure Trial Network; Palevsky PM, Zhang JH, O′Connor TZ, Chertow GM, Crowley ST, et al. Intensity of renal support in critically ill patients with acute kidney injury. N Engl J Med 2008;359:7-20.
Acute renal failure: definition, outcome measures, animal models, fluid therapy and information technology needs: The Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group. Crit Care 2004;8:R204-12.
RIFLE criteria for acute kidney injury is associated with hospital mortality in critical ill patients: A cohort analysis. Crit Care 2006;10:R73.
Effects of early high-volume continuous venovenous hemoltration on survival and recovery of renal function in intensive care patients with acute renal failure: A prospective, randomized trial. Crit Care Med 2002;30:2205-11.
Does hemodialysis delay recovery from ARF? Semin Dial 1990;3:146-8.
Changes in brain water with hemodialysis. Lancet 1986;2:1107-8.
Brain density changes during renal replacement in critically ill patients with acute renal failure: Continuous hemofiltration versus intermittent hemodialysis. J Nephrol 1999;12:173-8.
Arteriovenous haemofiltration: A new and simple method for treatment of overhydrated patients resistant to diuretics. Klin Wochenschr 1977;55:1121-2.
Pre-dilution vs. post-dilution during continuous veno-venous hemofiltration: Impact on filter life and azotemic control. Nephron Clin Pract 2003;94:c94-8.
Tunneled infusion catheters: Increased incidence of symptomatic venous thrombosis after subclavian versus internal jugular venous access. Radiology 2000;217:89-93.
Renal replacement therapy with high-cutoff hemofilters: Impact of convection and diffusion on cytokine clearances and protein status. Am J Kidney Dis 2004;43:444-53.
Continuous haemofiltration in acute renal failure with prostacyclin as the sole anti-haemostatic agent. Intensive Care Med 2002;28:586-93.
Novel approach for optimizing the capacity and efficacy of a protamine filter for clinical extracorporeal heparin removal. ASAIO 1998;5:M368-73.
Citrate anticoagulation during CVVH in high risk bleeding patients. Int J Artif Organs 2007;30:244-52.
Commercial low-citrate anticoagulation haemofiltration in high risk patients with frequent filter clotting. Anaesth Intensive Care 2007;30:244-52.
Anticoagulation for continuous renal replacement therapy. Curr Opin Anaesthesiol 2001;14:143-9.
A prospective study of the prevalence of heparin-induced antibodies and other associated thromboembolic risk factors in pediatric patients undergoing hemodialysis. Am J Hematol 2006;81:328-34
Factors affecting circuit patency and filter ′life′. Contrib Nephrol 2007;156:178-84.
Continuous renal replacement therapy is associated with less chronic renal failure than intermittent haemodialysis after acute renal failure. Intensive Care Med 2007;33:773-80.
Continuous versus intermittent renal replacement: A meta analysis. Intensive Care Med 2002;28:29-37.
A randomized, clinical trial of continuous versus intermittent dialysis for acute renal failure. Kidney Int 2001;60:1154- 63.
Continuous venovenous haemodiafiltration versus intermittent haemodialysis for acute renal failure in patients with multiple-organ dysfunction syndrome: A multicentre randomised trial. Lancet 2006;368:379-85.
Sustained low efficiency dialysis for critically ill patients requiring renal replacement therapy. Kidney Int 2001;60:777-85.
Sustained low-efficiency daily diafiltration (SLEDD- f) for critically ill patients requiring renal replacement therapy: towards an adequate therapy. Nephrol Dial Transplant. 2004 Apr;19(4):877-84.
