CRRT Effluent Dose KDIGO Recommendation — ESENeph MCQ
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Correct answer: E — 20-25 mL/kg/hr delivered dose
KDIGO AKI guidelines recommend a delivered CRRT effluent dose of 20-25 mL/kg/hr. This is based on the RENAL and ATN trials, which showed no benefit of higher-intensity CRRT (35-40 mL/kg/hr) over standard-intensity (20-25 mL/kg/hr). Importantly, the PRESCRIBED dose must be higher than 25 mL/kg/hr (typically 30 mL/kg/hr) because actual delivered dose is always lower due to filter clotting, interruptions for procedures, and circuit downtime. For an 85 kg man, the target delivered dose would be approximately 1700-2125 mL/hr. Doses <20 mL/kg/hr are associated with inadequate solute clearance.
Reference: KDIGO 2012 – AKI Guideline; Bellomo et al 2009 – RENAL Trial; VA/NIH ATN Trial 2008