A systematic review of cost-effectiveness analyses of continuous versus intermittent renal replacement therapy in acute kidney injury

  title={A systematic review of cost-effectiveness analyses of continuous versus intermittent renal replacement therapy in acute kidney injury},
  author={Ambrish Singh and Salman Hussain and Vijay Kher and Andrew J. Palmer and Matthew D Jose and Benny Antony},
  journal={Expert Review of Pharmacoeconomics \& Outcomes Research},
  pages={27 - 35}
ABSTRACT Introduction Though cost-effectiveness analyses (CEAs) have evaluated continuous renal replacement therapy (RRTs) and intermittent RRTs in acute kidney injury (AKI) patients; it is yet to establish which RRT technique is most cost-effective. We systematically reviewed the current evidence from CEAs of CRRT versus IRRT in patients with AKI. Areas covered PubMed, EMBASE, and Cochrane databases searched for CEAs comparing two RRTs. Overall, seven CEAs, two from Brazil and one from US… 


Economic evaluation of continuous renal replacement therapy in acute renal failure
IHD is the preferred modality in critically ill patients who are candidates for either intermittent hemodialysis or continuous renal replacement therapy, although this conclusion should be revisited if future clinical trials establish differences in clinical effectiveness between modalities.
Effects of continuous and intermittent renal replacement therapies among adult patients with acute kidney injury
Assessment of differences between CRRT and IRRT regarding important clinical outcomes and cost-effectiveness show that initial CRRT is associated with higher rates of renal recovery and transferability of the economic analyzes to the German health care system is limited.
Choice of renal replacement therapy modality and dialysis dependence after acute kidney injury: a systematic review and meta-analysis
Among AKI survivors, initial treatment with IRRT might be associated with higher rates of dialysis dependence than CRRT, however, this finding largely relies on data from observational trials, potentially subject to allocation bias, hence further high-quality studies are necessary.
Economic evaluation of different treatment modalities in acute kidney injury.
  • D. De Smedt, M. Elseviers, R. Lins, L. Annemans
  • Medicine, Political Science
    Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
  • 2012
This study has indicated that the most expensive treatment (CRRT) associated with an incremental cost of approximately €7920 generates only a minor non-significant increase in QALYs of 0.07 compared with IRRT, which seems to be the preferred treatment strategy from a health economic perspective.
Economics of dialysis dependence following renal replacement therapy for critically ill acute kidney injury patients
Initial CRRT is cost-effective compared with initial IRRT by reducing the rate of long-term dialysis dependence among critically ill AKI survivors.
Renal replacement therapy in patients with acute renal failure: a systematic review.
CONTEXT Acute renal failure requiring dialytic support is associated with a high risk of mortality and substantial morbidity. OBJECTIVES To summarize current evidence guiding provision of dialysis
Renal replacement therapy is an independent risk factor for mortality in critically ill patients with acute kidney injury
The SHARF study showed that the higher mortality expected in AKI patients receiving RRT versus conservative treatment can not only be explained by a higher disease severity in the RRT group, even after multiple corrections.