In a secondary analysis, we evaluated whether hemofiltration improved global organ dysfunction.Materials selleck chem inhibitor and methodsStudy designWe conducted an unblinded RCT of continuous venovenous hemofiltration (CVVH) vs. continuous venovenous hemodialysis (CVVHD) with concealed allocation (http://Clinicaltrials.gov registration number NCT00675818). Our reporting follows the updated CONSORT statement [8].SettingParticipants were recruited from ICUs at six academic hospitals: Mt. Sinai Hospital (Medical-Surgical ICU), Sunnybrook Health Sciences Centre (Critical Care Unit and Cardiovascular ICU) and St. Michael’s Hospital (Medical-Surgical and Cardiovascular ICUs), all in Toronto, Canada; Victoria Hospital (Critical Care Trauma Centre), and University Hospital (Medical/Surgical Intensive Care Unit and Cardiac Surgery Recovery Unit), both in London, Canada, and University of Alberta Hospital (General Systems Intensive Care Unit) in Edmonton, Canada.

The Research Ethics Boards of Mt. Sinai Hospital, St. Michael’s Hospital, Sunnybrook Health Sciences Centre, London Health Sciences Centre and the University of Alberta approved the protocol. The Applied Health Research Centre at St. Michael’s Hospital (Toronto, Ontario, Canada) was the trial coordinating center.PopulationWe enrolled critically ill adults (�� 16 years of age) with AKI, defined as a serum creatinine increase �� 50% from baseline (defined as the last known pre-morbid serum creatinine or earliest value available from the current admission).

At the time of screening, at least one of the following indications for RRT initiation needed to be present: (i) oliguria (defined as urine output < 100 mL in the preceding 4 hours); (ii) metabolic acidosis (serum bicarbonate < 15 mmol/L and pH < 7.25); (iii) refractory hyperkalemia (serum potassium > 6 mmol/L despite medical efforts at potassium removal); (iv) serum urea > 50 mmol/L, or (v) suspected uremic organ involvement (pericarditis, encephalopathy, neuropathy or myopathy). Finally, participants needed to be hemodynamically unstable, defined as Sequential Organ Failure Assessment (SOFA)- Cardiovascular Carfilzomib score �� 1 on the day of screening (see Additional file 1 for the modified SOFA score used in this study). This required the patient to have mean arterial pressure < 70 mmHg or receipt of at least one vasopressor or inotrope [9].