Research
Trial found more deaths with intermittent dialysis for acute kidney injury
By day 90, deaths occurred in 63.1% of patients assigned intermittent hemodialysis and 53.5% assigned continuous therapy.
A trial comparing intermittent hemodialysis with continuous renal-replacement therapy for critically ill patients with acute kidney injury was stopped early after its monitoring board found a higher mortality signal in the intermittent-treatment group, MedPage Today reported.
In the intention-to-treat analysis of 535 patients, a major adverse kidney event by day 90, the trial’s primary outcome, occurred in 78.1% of the intermittent group and 71.6% of the continuous group. Deaths by day 90 occurred in 63.1% and 53.5%, respectively. The trial enrolled 554 participants and had originally planned to enroll 1,000.
The researchers noted that early stopping may have reduced the precision of the estimates and led to an overestimate of the mortality effect. Assigned therapies were maintained for at least 4 consecutive days unless kidney recovery occurred, after which clinicians could switch treatments. The trial does not establish which approach is preferable after the first 3 days.
