Comparing Low vs. Standard Dose-Intensity Continuous Renal Replacement Therapy in Critically Ill Adults with Acute Kidney Injury

What this Trial Is About

This trial evaluates the effects of different dose-intensities of continuous renal replacement therapy CRRT in critically ill patients with acute kidney injury AKI in the intensive care unit. The main goal is to compare the current standard CRRT dose-intensity with a lower dose to see if the lower dose is not worse and might improve kidney recovery and shorten the duration of CRRT. The study addresses the lack of clear evidence on the minimum effective CRRT dose and aims to generate high-quality data that could influence clinical guidelines and practice. Participants will be randomly assigned to receive either a low dose-intensity CRRT of 10-15 mLkghour or the standard dose-intensity of 25-30 mLkghour while on CRRT. The lower dose is based on observational data suggesting it may be safe and well tolerated. The trial is a pilot feasibility study designed to inform a larger randomized controlled trial. Treatments will be delivered continuously while patients are in the ICU needing CRRT. During the study, participants will be monitored for the delivered CRRT dose-intensity over about one month. Researchers will assess feasibility factors such as consent rate, adherence to dose, recruitment rate, and outcome ascertainment up to 90 days. The primary outcome focuses on the difference in CRRT dose delivered. Participants will receive regular evaluations to track kidney recovery, time on CRRT, and overall treatment effects. The trial runs from November 2024 to June 2027.

LoW Dose-Intensity vs. Standard Dose-Intensity COntinuous Renal ReplaceMent Therapy in Critically Ill Patients (WISDOM)