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CRRT Dose Prescription — ESENeph MCQ

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ModerateAcute Kidney InjuryCRRT Dose PrescriptionESENeph

A 68-year-old man with septic shock from pneumonia is in ICU on vasopressors. His creatinine was 85 umol/L on admission and is now 310 umol/L at 24 hours. He is anuric. Continuous renal replacement therapy (CRRT) is started. According to KDIGO 2012, what effluent dose should be delivered?

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Correct answer: E — 20-25 mL/kg/hr

KDIGO 2012 AKI guideline recommends delivering an effluent dose of 20-25 mL/kg/hr for CRRT in critically ill patients with AKI. Higher doses (e.g. 35-40 mL/kg/hr) did not improve outcomes in the ATN or RENAL trials. Actual delivered dose is often lower than prescribed due to filter downtime, so prescribing slightly above target (e.g. 25-30) may be needed to achieve 20-25 delivered.

Reference: KDIGO 2012 – AKI Guideline; RENAL Trial – NEJM 2009