Design and challenges of the Randomized Evaluation of Normal versus Augmented Level Replacement Therapy (RENAL) Trial: High-dose versus standard-dose hemofiltration in acute renal failure

Rinaldo Bellomo, Alan Cass, Louise Cole, Simon Finfer, Martin Gallagher, Donna Goldsmith, John Myburgh, Robyn Norton, Carlos Scheinkestel, Ashoke Banarjee, Deepk Bhonagiri, David Blythe, John Botha, John Cade, Geoff Dobb, John Eddington, Arthas Flabouris, Craig French, Peter Garrett, Seton Henderson & 17 others Benno Ihle, Chris Joyce, Michael Kalkoff, Jeff Lipman, Colin McArthur, Shay McGinness, David Milliss, Imogen Mitchell, John Morgan, Priya Nair, Neil Orford, Asif Raza, Yahya Shehabi, Antony Tobin, Richard Totaro, Andrew Turner, Christopher Wright

Research output: Contribution to journalReview ArticleResearchpeer-review

Abstract

Background/Aims: The optimal dose of renal replacement therapy (RRT) in acute renal failure (ARF) is uncertain. Methods: The Randomized Evaluation of Normal versus Augmented Level Replacement Therapy Trial tests the hypothesis that higher dose continuous veno-venous hemodiafiltration (CVVHDF) at an effluent rate of 40 ml/kg/h will increase survival compared to CVVHDF at 25 ml/kg/h of effluent dose. Results: This trial is currently randomizing critically ill patients in 35 intensive care units in Australia and New Zealand with a planned sample size of 1,500 patients. This trial will be the largest trial ever conducted on acute blood purification in critically ill patients. Conclusion: A trial of this magnitude and with demanding technical requirements poses design difficulties and challenges in the logistics, conduct, data collection, data analysis and monitoring. Our report will assist in the development of future trials of blood purification in intensive care. This study was registered with ClinicalTrials.gov (NCT00221013).

Original languageEnglish
Pages (from-to)407-416
Number of pages10
JournalBlood Purification
Volume26
Issue number5
DOIs
Publication statusPublished - 1 Oct 2008

Keywords

  • Acute renal failure
  • Continuous hemodiafiltration
  • Dialysis
  • Intensive care
  • Kidney
  • Renal replacement therapy, continuous

Cite this

Bellomo, Rinaldo ; Cass, Alan ; Cole, Louise ; Finfer, Simon ; Gallagher, Martin ; Goldsmith, Donna ; Myburgh, John ; Norton, Robyn ; Scheinkestel, Carlos ; Banarjee, Ashoke ; Bhonagiri, Deepk ; Blythe, David ; Botha, John ; Cade, John ; Dobb, Geoff ; Eddington, John ; Flabouris, Arthas ; French, Craig ; Garrett, Peter ; Henderson, Seton ; Ihle, Benno ; Joyce, Chris ; Kalkoff, Michael ; Lipman, Jeff ; McArthur, Colin ; McGinness, Shay ; Milliss, David ; Mitchell, Imogen ; Morgan, John ; Nair, Priya ; Orford, Neil ; Raza, Asif ; Shehabi, Yahya ; Tobin, Antony ; Totaro, Richard ; Turner, Andrew ; Wright, Christopher. / Design and challenges of the Randomized Evaluation of Normal versus Augmented Level Replacement Therapy (RENAL) Trial : High-dose versus standard-dose hemofiltration in acute renal failure. In: Blood Purification. 2008 ; Vol. 26, No. 5. pp. 407-416.
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abstract = "Background/Aims: The optimal dose of renal replacement therapy (RRT) in acute renal failure (ARF) is uncertain. Methods: The Randomized Evaluation of Normal versus Augmented Level Replacement Therapy Trial tests the hypothesis that higher dose continuous veno-venous hemodiafiltration (CVVHDF) at an effluent rate of 40 ml/kg/h will increase survival compared to CVVHDF at 25 ml/kg/h of effluent dose. Results: This trial is currently randomizing critically ill patients in 35 intensive care units in Australia and New Zealand with a planned sample size of 1,500 patients. This trial will be the largest trial ever conducted on acute blood purification in critically ill patients. Conclusion: A trial of this magnitude and with demanding technical requirements poses design difficulties and challenges in the logistics, conduct, data collection, data analysis and monitoring. Our report will assist in the development of future trials of blood purification in intensive care. This study was registered with ClinicalTrials.gov (NCT00221013).",
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author = "Rinaldo Bellomo and Alan Cass and Louise Cole and Simon Finfer and Martin Gallagher and Donna Goldsmith and John Myburgh and Robyn Norton and Carlos Scheinkestel and Ashoke Banarjee and Deepk Bhonagiri and David Blythe and John Botha and John Cade and Geoff Dobb and John Eddington and Arthas Flabouris and Craig French and Peter Garrett and Seton Henderson and Benno Ihle and Chris Joyce and Michael Kalkoff and Jeff Lipman and Colin McArthur and Shay McGinness and David Milliss and Imogen Mitchell and John Morgan and Priya Nair and Neil Orford and Asif Raza and Yahya Shehabi and Antony Tobin and Richard Totaro and Andrew Turner and Christopher Wright",
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Bellomo, R, Cass, A, Cole, L, Finfer, S, Gallagher, M, Goldsmith, D, Myburgh, J, Norton, R, Scheinkestel, C, Banarjee, A, Bhonagiri, D, Blythe, D, Botha, J, Cade, J, Dobb, G, Eddington, J, Flabouris, A, French, C, Garrett, P, Henderson, S, Ihle, B, Joyce, C, Kalkoff, M, Lipman, J, McArthur, C, McGinness, S, Milliss, D, Mitchell, I, Morgan, J, Nair, P, Orford, N, Raza, A, Shehabi, Y, Tobin, A, Totaro, R, Turner, A & Wright, C 2008, 'Design and challenges of the Randomized Evaluation of Normal versus Augmented Level Replacement Therapy (RENAL) Trial: High-dose versus standard-dose hemofiltration in acute renal failure' Blood Purification, vol. 26, no. 5, pp. 407-416. https://doi.org/10.1159/000148400

Design and challenges of the Randomized Evaluation of Normal versus Augmented Level Replacement Therapy (RENAL) Trial : High-dose versus standard-dose hemofiltration in acute renal failure. / Bellomo, Rinaldo; Cass, Alan; Cole, Louise; Finfer, Simon; Gallagher, Martin; Goldsmith, Donna; Myburgh, John; Norton, Robyn; Scheinkestel, Carlos; Banarjee, Ashoke; Bhonagiri, Deepk; Blythe, David; Botha, John; Cade, John; Dobb, Geoff; Eddington, John; Flabouris, Arthas; French, Craig; Garrett, Peter; Henderson, Seton; Ihle, Benno; Joyce, Chris; Kalkoff, Michael; Lipman, Jeff; McArthur, Colin; McGinness, Shay; Milliss, David; Mitchell, Imogen; Morgan, John; Nair, Priya; Orford, Neil; Raza, Asif; Shehabi, Yahya; Tobin, Antony; Totaro, Richard; Turner, Andrew; Wright, Christopher.

In: Blood Purification, Vol. 26, No. 5, 01.10.2008, p. 407-416.

Research output: Contribution to journalReview ArticleResearchpeer-review

TY - JOUR

T1 - Design and challenges of the Randomized Evaluation of Normal versus Augmented Level Replacement Therapy (RENAL) Trial

T2 - High-dose versus standard-dose hemofiltration in acute renal failure

AU - Bellomo, Rinaldo

AU - Cass, Alan

AU - Cole, Louise

AU - Finfer, Simon

AU - Gallagher, Martin

AU - Goldsmith, Donna

AU - Myburgh, John

AU - Norton, Robyn

AU - Scheinkestel, Carlos

AU - Banarjee, Ashoke

AU - Bhonagiri, Deepk

AU - Blythe, David

AU - Botha, John

AU - Cade, John

AU - Dobb, Geoff

AU - Eddington, John

AU - Flabouris, Arthas

AU - French, Craig

AU - Garrett, Peter

AU - Henderson, Seton

AU - Ihle, Benno

AU - Joyce, Chris

AU - Kalkoff, Michael

AU - Lipman, Jeff

AU - McArthur, Colin

AU - McGinness, Shay

AU - Milliss, David

AU - Mitchell, Imogen

AU - Morgan, John

AU - Nair, Priya

AU - Orford, Neil

AU - Raza, Asif

AU - Shehabi, Yahya

AU - Tobin, Antony

AU - Totaro, Richard

AU - Turner, Andrew

AU - Wright, Christopher

PY - 2008/10/1

Y1 - 2008/10/1

N2 - Background/Aims: The optimal dose of renal replacement therapy (RRT) in acute renal failure (ARF) is uncertain. Methods: The Randomized Evaluation of Normal versus Augmented Level Replacement Therapy Trial tests the hypothesis that higher dose continuous veno-venous hemodiafiltration (CVVHDF) at an effluent rate of 40 ml/kg/h will increase survival compared to CVVHDF at 25 ml/kg/h of effluent dose. Results: This trial is currently randomizing critically ill patients in 35 intensive care units in Australia and New Zealand with a planned sample size of 1,500 patients. This trial will be the largest trial ever conducted on acute blood purification in critically ill patients. Conclusion: A trial of this magnitude and with demanding technical requirements poses design difficulties and challenges in the logistics, conduct, data collection, data analysis and monitoring. Our report will assist in the development of future trials of blood purification in intensive care. This study was registered with ClinicalTrials.gov (NCT00221013).

AB - Background/Aims: The optimal dose of renal replacement therapy (RRT) in acute renal failure (ARF) is uncertain. Methods: The Randomized Evaluation of Normal versus Augmented Level Replacement Therapy Trial tests the hypothesis that higher dose continuous veno-venous hemodiafiltration (CVVHDF) at an effluent rate of 40 ml/kg/h will increase survival compared to CVVHDF at 25 ml/kg/h of effluent dose. Results: This trial is currently randomizing critically ill patients in 35 intensive care units in Australia and New Zealand with a planned sample size of 1,500 patients. This trial will be the largest trial ever conducted on acute blood purification in critically ill patients. Conclusion: A trial of this magnitude and with demanding technical requirements poses design difficulties and challenges in the logistics, conduct, data collection, data analysis and monitoring. Our report will assist in the development of future trials of blood purification in intensive care. This study was registered with ClinicalTrials.gov (NCT00221013).

KW - Acute renal failure

KW - Continuous hemodiafiltration

KW - Dialysis

KW - Intensive care

KW - Kidney

KW - Renal replacement therapy, continuous

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U2 - 10.1159/000148400

DO - 10.1159/000148400

M3 - Review Article

VL - 26

SP - 407

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JO - Blood Purification

JF - Blood Purification

SN - 0253-5068

IS - 5

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