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Table 2 Subanalysis of the VA/NIH ATN and the RENAL studies

From: Findings from two large randomized controlled trials on renal replacement therapy in acute kidney injury

Topics   Author (year) Ref Main result
Dose VA/NIH ATN Palevsky (2008) [5] No difference in 60-day mortality between the intensive and less intensive groups
RENAL Bellomo (2009) [6] No difference in 90-day mortality between the higher and lower intensity groups
RENAL Bellomo (2013) [8] No difference in base excess correction between the higher and lower intensity groups. The higher intensity group had a greater increase in MAP and a decrease in norepinephrine dose.
VA/NIH ATN Overberger (2007) [9] Intermittent hemodialysis and CRRT were the most commonly used RRT modalities in the USA. Most practitioners neither dosed CRRT based on patient weight nor routinely assessed the delivered dosage of hemodialysis.
Timing RENAL Jun (2014) [16] Earlier commencement of continuous RRT relative to RIFLE-I AKI onset was not significantly associated with improved mortality.
Risk prediction VA/NIH ATN Demirjian (2011) [20] 21 independent predictors of 60-day mortality were identified. The new risk model outperformed existing generic and disease-specific scoring systems in predicting 60-day mortality.
Drug RENAL Wang (2014) [23] The use of ACE-I during the study was not common and, after adjustment for time-dependent covariates, was not significantly associated with reductions in mortality.
RENAL Roberts (2015) [25] CRRT dose did not influence overall (systemic) antibiotic clearance, volume of distribution, or half-life. The proportion of systemic clearance due to CRRT varied widely.
Nutrition RENAL Bellomo (2014) [36] Mean DPI was markedly below current recommendations. On multivariate analysis, a lower DPI was not associated with increased 90-day mortality.
RENAL Bellomo (2014) [32] Mean DCI during treatment in ICU was low. On multivariable analysis, DCI was not associated with a significant difference in 90-day mortality.
Renal recovery VA/NIH ATN Srisawat (2011) [41] For predicting renal recovery, decreasing urine biomarkers in the first 14 days was associated with greater odds of renal recovery.
Quality of life VA/NIH ATN Johansen (2010) [43] Health utility was low in this cohort of patients after AKI, and intensity of dialysis did not affect subsequent health utility.
VA/NIH ATN Joyce (2012) [44] HRQOL was an independent predictor of mortality among survivors of AKI after adjusting for clinical risk variables.
RENAL Wang (2015) [45] Survivors of severe AKI in the study had lower physical and mental components of HRQOL compared with the general population, even after adjustment for reduced renal function.
  1. ACE-I angiotensin-converting enzyme inhibitor, AKI acute renal failure, ATN Acute Renal Failure Trial, CRRT continuous renal replacement therapy, DCI delivery of caloric intake, DPI daily protein intake, HRQOL Health-related quality of life, MAP mean arterial pressure, ICU intensive care unit, RENAL Randomized Evaluation of Normal versus Augmented Level, RIFLE-I Risk, Injury, Failure, Loss, End-stage kidney disease (injury), VA/NIH The Veterans Affairs/National Institutes of Health