Comparison of sustained low-efficiency dialysis and continuous renal replacement therapy in patients in the intensive care unit with acute kidney injury: A search for a safe and rapid therapeutic approach

INTRODUCTION: In recent years, sustained low-efficiency dialysis (SLED) has emerged as a viable alternative to continuous renal replacement therapy (CRRT) for critically ill patients experiencing acute kidney injury (AKI). The aim of the study is to compare SLED with CRRT in patients with acute kidn...

Full description

Saved in:
Bibliographic Details
Main Authors: Satyanarayana Garre, Swarna Deepak Kuragayala, Somashekar Mudigonda
Format: Article
Language:English
Published: Towarzystwo Pomocy Doraźnej 2025-06-01
Series:Critical Care Innovations
Subjects:
Online Access:https://www.irdim.net/cci/8(2)21-33.html
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849422737976590336
author Satyanarayana Garre
Swarna Deepak Kuragayala
Somashekar Mudigonda
author_facet Satyanarayana Garre
Swarna Deepak Kuragayala
Somashekar Mudigonda
author_sort Satyanarayana Garre
collection DOAJ
description INTRODUCTION: In recent years, sustained low-efficiency dialysis (SLED) has emerged as a viable alternative to continuous renal replacement therapy (CRRT) for critically ill patients experiencing acute kidney injury (AKI). The aim of the study is to compare SLED with CRRT in patients with acute kidney injury (AKI). MATERIALS AND METHODS: This observational cohort was conducted in 52 patients with AKI, and all patients were assigned into two groups; sustained low-efficiency dialysis (SLED, n=26) and continuous renal replacement therapy (CRRT, n=26). Outcomes such as mortality, mechanical ventilation requirement and SOFA score at 0 hour and 48 hour of replacement therapy, cumulative fluid removal in 7 days following replacement therapy in were analysed. RESULTS: The morality at 30 days is 38.4% (10/26) in the SLED group and 57.7%(15/26) in the CRRT group. There were 19.2% and 23.07% of the cases dependent on dialysis at 30 days in CRRT and SLED groups (p<0.05). The mean SOFA score was higher in the SLED group than in the CRRT group at 0 hour (15.385 ± 0.451 vs. 14.846 ± 0.414). It was 15.5 ± 0.713 and 14.923 ± 0.612 in the CRRT and SLED groups at 12hrs (p>0.05). The mean SOFA score at 24 hours was 14.143 ± 1.214 and 13.955 ± 0.76 the in CRRT and SLED groups (p>0.05). After 48 hours of RRT initiation, SOFA drops to 10.813 ± 1.603 and 12.1 ± 0.948 in the CRRT and SLED groups (p<0.05). CONCLUSIONS: Primary outcome mortality was 57.7% cases in the CRRT group, while 38.4% in the SLED group (p=0.16). Secondary outcomes such as dialysis dependence at 30 days and early clinical deterioration, showed no difference across groups. SLED is a viable alternative to CRRT for hemodynamically unstable patients with AKI.
format Article
id doaj-art-65593b3bdb3b4d01bb4f27fe9ca64e86
institution Kabale University
issn 2545-2533
language English
publishDate 2025-06-01
publisher Towarzystwo Pomocy Doraźnej
record_format Article
series Critical Care Innovations
spelling doaj-art-65593b3bdb3b4d01bb4f27fe9ca64e862025-08-20T03:30:56ZengTowarzystwo Pomocy DoraźnejCritical Care Innovations2545-25332025-06-0182213310.32114/CCI.2025.8.2.21.33Comparison of sustained low-efficiency dialysis and continuous renal replacement therapy in patients in the intensive care unit with acute kidney injury: A search for a safe and rapid therapeutic approachSatyanarayana Garrehttps://orcid.org/0009-0001-6239-7483Swarna Deepak Kuragayalahttps://orcid.org/0000-0001-6817-307XSomashekar Mudigondahttps://orcid.org/0009-0005-7775-2301INTRODUCTION: In recent years, sustained low-efficiency dialysis (SLED) has emerged as a viable alternative to continuous renal replacement therapy (CRRT) for critically ill patients experiencing acute kidney injury (AKI). The aim of the study is to compare SLED with CRRT in patients with acute kidney injury (AKI). MATERIALS AND METHODS: This observational cohort was conducted in 52 patients with AKI, and all patients were assigned into two groups; sustained low-efficiency dialysis (SLED, n=26) and continuous renal replacement therapy (CRRT, n=26). Outcomes such as mortality, mechanical ventilation requirement and SOFA score at 0 hour and 48 hour of replacement therapy, cumulative fluid removal in 7 days following replacement therapy in were analysed. RESULTS: The morality at 30 days is 38.4% (10/26) in the SLED group and 57.7%(15/26) in the CRRT group. There were 19.2% and 23.07% of the cases dependent on dialysis at 30 days in CRRT and SLED groups (p<0.05). The mean SOFA score was higher in the SLED group than in the CRRT group at 0 hour (15.385 ± 0.451 vs. 14.846 ± 0.414). It was 15.5 ± 0.713 and 14.923 ± 0.612 in the CRRT and SLED groups at 12hrs (p>0.05). The mean SOFA score at 24 hours was 14.143 ± 1.214 and 13.955 ± 0.76 the in CRRT and SLED groups (p>0.05). After 48 hours of RRT initiation, SOFA drops to 10.813 ± 1.603 and 12.1 ± 0.948 in the CRRT and SLED groups (p<0.05). CONCLUSIONS: Primary outcome mortality was 57.7% cases in the CRRT group, while 38.4% in the SLED group (p=0.16). Secondary outcomes such as dialysis dependence at 30 days and early clinical deterioration, showed no difference across groups. SLED is a viable alternative to CRRT for hemodynamically unstable patients with AKI.https://www.irdim.net/cci/8(2)21-33.htmllow-dose slow dialysiscontinuous renal replacement therapyacute kidney injuryintermittent hemodynamic therapy
spellingShingle Satyanarayana Garre
Swarna Deepak Kuragayala
Somashekar Mudigonda
Comparison of sustained low-efficiency dialysis and continuous renal replacement therapy in patients in the intensive care unit with acute kidney injury: A search for a safe and rapid therapeutic approach
Critical Care Innovations
low-dose slow dialysis
continuous renal replacement therapy
acute kidney injury
intermittent hemodynamic therapy
title Comparison of sustained low-efficiency dialysis and continuous renal replacement therapy in patients in the intensive care unit with acute kidney injury: A search for a safe and rapid therapeutic approach
title_full Comparison of sustained low-efficiency dialysis and continuous renal replacement therapy in patients in the intensive care unit with acute kidney injury: A search for a safe and rapid therapeutic approach
title_fullStr Comparison of sustained low-efficiency dialysis and continuous renal replacement therapy in patients in the intensive care unit with acute kidney injury: A search for a safe and rapid therapeutic approach
title_full_unstemmed Comparison of sustained low-efficiency dialysis and continuous renal replacement therapy in patients in the intensive care unit with acute kidney injury: A search for a safe and rapid therapeutic approach
title_short Comparison of sustained low-efficiency dialysis and continuous renal replacement therapy in patients in the intensive care unit with acute kidney injury: A search for a safe and rapid therapeutic approach
title_sort comparison of sustained low efficiency dialysis and continuous renal replacement therapy in patients in the intensive care unit with acute kidney injury a search for a safe and rapid therapeutic approach
topic low-dose slow dialysis
continuous renal replacement therapy
acute kidney injury
intermittent hemodynamic therapy
url https://www.irdim.net/cci/8(2)21-33.html
work_keys_str_mv AT satyanarayanagarre comparisonofsustainedlowefficiencydialysisandcontinuousrenalreplacementtherapyinpatientsintheintensivecareunitwithacutekidneyinjuryasearchforasafeandrapidtherapeuticapproach
AT swarnadeepakkuragayala comparisonofsustainedlowefficiencydialysisandcontinuousrenalreplacementtherapyinpatientsintheintensivecareunitwithacutekidneyinjuryasearchforasafeandrapidtherapeuticapproach
AT somashekarmudigonda comparisonofsustainedlowefficiencydialysisandcontinuousrenalreplacementtherapyinpatientsintheintensivecareunitwithacutekidneyinjuryasearchforasafeandrapidtherapeuticapproach