{"id":31961,"date":"2026-10-23T04:18:00","date_gmt":"2026-10-22T20:18:00","guid":{"rendered":"https:\/\/csccm.org.cn\/?p=31961"},"modified":"2026-10-23T05:48:58","modified_gmt":"2026-10-22T21:48:58","slug":"nejm%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e6%80%a5%e6%80%a7%e8%82%be%e6%8d%9f%e4%bc%a4%e7%9a%84%e9%97%b4%e6%96%ad%e6%88%96%e6%8c%81%e7%bb%ad%e8%82%be%e8%84%8f%e6%9b%bf%e4%bb%a3%e6%b2%bb","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=31961","title":{"rendered":"[NEJM\u53d1\u8868\u8bba\u6587]\uff1a\u6025\u6027\u80be\u635f\u4f24\u7684\u95f4\u65ad\u6216\u6301\u7eed\u80be\u810f\u66ff\u4ee3\u6cbb\u7597"},"content":{"rendered":"\n

ORIGINAL ARTICLE<\/a><\/p>\n\n\n\n

Intermittent or Continuous Renal-Replacement Therapy in Acute Kidney Injury<\/h1>\n\n\n\n

St\u00e9phane\u00a0Gaudry,\u00a0Marouane\u00a0Boubaya,\u00a0Guillaume\u00a0Louis,\u00a0et al<\/h3>\n\n\n\n

N Engl J Med Published\u00a0October 14, 2026<\/h3>\n\n\n\n

DOI: 10.1056\/NEJMoa2608397<\/h3>\n\n\n\n

Abstract<\/h2>\n\n\n\n

BACKGROUND<\/h3>\n\n\n\n

The preferred method of renal-replacement therapy for acute kidney injury in critically ill patients remains uncertain.<\/p>\n\n\n\n

METHODS<\/h3>\n\n\n\n

In this multicenter, open-label, noninferiority trial, we randomly assigned critically ill adults with acute kidney injury who had indications for renal-replacement therapy to undergo intermittent hemodialysis or continuous renal-replacement therapy as the initial treatment. The primary outcome was a major adverse kidney event \u2014 defined as death, dependence on renal-replacement therapy, or a serum creatinine concentration more than 25% above the baseline value \u2014 by day 90.<\/p>\n\n\n\n

RESULTS<\/h3>\n\n\n\n

The trial was stopped early after sequential interim analyses showed a sustained signal of higher mortality with intermittent hemodialysis than with continuous renal-replacement therapy. A total of 554 patients underwent randomization, with 272 patients assigned to undergo intermittent hemodialysis and 282 to undergo continuous renal-replacement therapy; 535 patients (260 in the intermittent group and 275 in the continuous group) were included in the intention-to-treat population. A major adverse kidney event occurred by day 90 in 203 patients (78.1%) in the intermittent group and in 197 patients (71.6%) in the continuous group (adjusted absolute risk difference, 6.28 percentage points; 95% confidence interval [CI], \u22121.22 to 13.79). Death by day 90 occurred in 164 patients (63.1%) and in 147 patients (53.5%), respectively. Kaplan\u2013Meier mortality estimates at day 90 were 63.3% and 53.6% (hazard ratio, 1.30; 95% CI, 1.04 to 1.63). The most common complication potentially related to acute kidney injury or renal-replacement therapy was hypotension, which occurred in 179 patients (68.8%) in the intermittent group and in 183 patients (66.5%) in the continuous group.<\/p>\n\n\n\n

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CONCLUSIONS<\/h3>\n\n\n\n

Among critically ill patients with acute kidney injury who had indications for renal-replacement therapy, intermittent hemodialysis as the initial treatment approach was not shown to be noninferior to continuous renal-replacement therapy with respect to major adverse kidney events by day 90 and was associated with higher mortality. (Funded by the French Ministry of Health; ICRAKI ClinicalTrials.gov number, NCT06032884<\/a>.)<\/p>\n","protected":false},"excerpt":{"rendered":"

ORIGINAL ARTICLE Intermittent or Continuous Renal-Repla […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/31961"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=31961"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/31961\/revisions"}],"predecessor-version":[{"id":31967,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/31961\/revisions\/31967"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=31961"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=31961"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=31961"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}