Low-intensity Versus Medium-intensity Continuous Kidney Replacement Therapy for Critically Ill Patients

Inclusion criteria

Patient who meets all of the following criteria and who has given informed consent.

• Adults (18 years of age or older, regardless of the time since ICU admission) currently admitted to an intensive care unit*.

*Includes high care units, where continuous monitoring is conducted and intensive care physicians are in charge of medical care.

• A diagnosis of acute kidney injury is made according to the Kidney Disease: Improving Global Outcomes (KDIGO) international diagnostic criteria (one of the following is met)

• Serum creatinine increased by more than 0.3 mg/dL within 48 hours
• Serum creatinine increased more than 1.5-fold from baseline and the increase is considered to have occurred within 7 days
• Oliguria (< 0.5 mL/kg/hr) lasting more than 6 hours
• The treating intensivist believes that continuous kidney replacement therapy is necessary

Exclusion criteria

Patient who meets any of the following exclusion criteria will be excluded.

• Receiving chronic dialysis or scheduled for initiation of chronic dialysis
• Undergoing any kidney replacement therapy or blood purification therapy within 48 hours
• When kidney replacement therapy using other dialysate or replacement fluids, such as citrate dialysis, is preferred due to coexisting bleeding disorders or allergy to acetate
• Concomitant blood purification therapy other than hemofiltration/dialysis, such as plasma exchange
• The patient is in a very critical condition and the treating physician believes that survival for more than 24 hours is unlikely
• Previous participation in the study
• After receiving a full explanation of the study and with full understanding, a patient do not consent to participate in the study of their own (or their substitute decision maker's) will.
• The principal investigator (or an investigator) thinks it to be inappropriate to participate in this study.