A pilot randomized controlled trial of comparison between extended daily hemodialysis and continuous veno-venous hemodialysis in patients of acute kidney injury with septic shock

JOURNAL TITLE: Indian Journal of Critical Care Medicine

Author
1. Arvind Kumar Baronia
2. Ratendra Kumar Singh
ISSN
0972-5229
DOI
10.4103/ijccm.IJCCM_85_17
Volume
21
Issue
5
Publishing Year
2017
Pages
6
Author Affiliations
    1. Department of Critical Care Medicine, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
    1. Department of Critical Care Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
  • Article keywords
    Acute kidney injury, dialysis, septic shock

    Abstract

    Aim of Study: Acute kidney injury (AKI) is common in patients of septic shock. There is sparse data comparing sustained low-efficiency dialysis (SLED) and continuous renal replacement therapy (CRRT) in patients with septic shock. Materials and Methods: This is a prospective randomized study in a 12-bedded medical intensive care unit. After clearance from institute′s ethics committee and obtaining informed consent from the relatives, sixty adult patients with septic shock who were to undergo dialysis for AKI were included in the study. They were randomly assigned to SLED or CRRT group. Hemodynamic instability was defined as in terms of vasopressor dependency (VD). The worst value of VD during the dialysis session was taken into consideration. The primary objective was look at hemodynamic changes and secondarily into the efficacy. Results: The demographic data were comparable between the sixty patients randomized to thirty in each group. Delta VD and delta vasopressor index (DVI) were similar in SLED group compared to the CRRT group. CRRT group had better efficacy in terms of both equivalent renal urea clearance though fluid balance was not significantly better in CRRT group. Conclusion: SLED is a viable modality of renal replacement therapy in patients with septic shock as the hemodynamic effects are similar to CRRT.

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