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Lower versus standard dose-intensity continuous renal replacement therapy: a protocol for a systematic review and
Nuttha Lumlertgul1, Prit Kusirisin2,3, Janice Y Kung4
1Division of Nephrology, Department of Medicine, Excellence for Critical Care Nephrology, King Chulalongkorn Memorial Hospital and Centre of Excellence in Critical Care Nephrology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand nlumlertgul@gmail.com.
BMJ Open
|January 30, 2026
Summary
Lower-dose continuous renal replacement therapy (CRRT) may be safe and effective for acute kidney injury (AKI) patients. This systematic review compares lower CRRT doses to guideline-recommended doses to assess tolerability and outcomes.
Area of Science:
- Nephrology
- Critical Care Medicine
Background:
- Current guidelines recommend continuous renal replacement therapy (CRRT) doses of 20-25 mL/kg/hour for acute kidney injury (AKI).
- Observational data suggest lower CRRT doses (<20 mL/kg/hour) might be tolerated and reduce adverse effects.
- There is a need to systematically evaluate the evidence on lower CRRT dose intensity.
Purpose of the Study:
- To conduct a systematic review and meta-analysis.
- To compare tolerability, safety, and clinical outcomes of lower CRRT dose-intensity versus guideline-directed standard dose-intensity CRRT.
- To synthesize current evidence on CRRT dosing in AKI patients.
Main Methods:
- Systematic search of Ovid MEDLINE, Embase, CINAHL, and Cochrane Library.
- Inclusion of randomized controlled trials and cohort studies involving AKI patients receiving CRRT.
- Assessment of risk of bias using modified Cochrane tools.
- Data extraction and bias assessment by two independent reviewers.
- Meta-analysis of pooled outcomes, including mortality and dialysis dependence, using random-effects models.
Main Results:
- This section is to be populated upon study completion.
Conclusions:
- This section is to be populated upon study completion.
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