Lower versus standard dose-intensity continuous renal replacement therapy: a systematic review and meta-analysis
Pooled result · ICU mortality (6 studies)Result — go to the resultOdds ratio 0.77 95% CI 0.60–0.98Authors' conclusion
Among critically ill adults with AKI receiving CRRT, lower dose-intensity therapy was not associated with increased ICU mortality. Other key clinical endpoints were comparable, based on very low certainty of evidence.
Study context
- Population
- Adults with AKI receiving continuous renal replacement therapy (CRRT)14 studies (3 randomized controlled trials (RCTs), 11 cohorts)
- Participants
- 5,318 adults
- Comparison
- Lower vs guideline-directed standard dose-intensity CRRT
- Outcome
- ICU mortality
Methodological detailsGRADE certainty assessment, RCTs had moderate risk of bias, most cohort studies serious risk
- GRADE certainty assessment
- RCTs had moderate risk of bias, most cohort studies serious risk
Pooled result
ICU mortality (6 studies)
Odds ratio
0.77
95% CI 0.60–0.98
P = 0.04
Lower dose-intensity vs Standard dose-intensity
OR 0.77 (95% CI 0.60–0.98); P = 0.04
As reported in the abstract
Further pooled results
90-day mortality, very low dose-intensity (< 13 mL/kg/hr) (subgroup)
| OR (95% CI) | P value | ||
|---|---|---|---|
| Very low dose-intensity (< 13 mL/kg/hr)I2 = 0%; very low certainty · subgroup analysis | 1.72 (1.31–2.24) | P < 0.001 | |
| 0.512Odds ratio (log scale) |
Intensive care unit (ICU) mortality, sensitivity analysis (Hartung-Knapp Sidik-Jonkmann model)
- No difference in ICU mortality between groups
- OR 0.77 [95% CI; p = 0.10, 0.55-1.08]
- Sensitivity analysis
Dialysis duration, dialysis dependence at discharge, hospital LOS, mechanical ventilation duration
- No significant differences between groups
Original publication
Lower versus standard dose-intensity continuous renal replacement therapy: a systematic review and meta-analysis. Crit Care. Published 27 March 2026. doi:10.
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