Will you implement the conservative dialysis strategy from the LIBERATE-D trial for patients with dialysis-requiring acute kidney injury, or will you continue dialysis on a schedule until recovery based on creatinine and urine output?

In the LIBERATE-D trial, patients in the conservative dialysis group underwent dialysis only when meeting criteria such as serum urea nitrogen >112 mg/dL, hyperkalemia with potassium >6 mmol/L or more than 5.5 mmol/L despite medical treatment, metabolic acidosis with pH <7.15, severe pulmonary edema causing significant hypoxemia, or clinician judgment.

Answer from: at Academic Institution

I think I have always dialyzed patients with AKI on an as-needed basis. The question is whether to follow the parameters set by the LIBERATE-D study (bun >112, etc.). I am not yet sure what my practice will look like in the future as far as the parameters. It is likely the case, though, that I wo...

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at Ohio State University Wexner Medical Center
What parameters guide your approach?

Answer from: at Academic Institution

The real problem is fluid. Patients with ATN are often oliguric, and we all know that ICU patients are almost always fluid overloaded. Even with 3 days per week dialysis, it is hard to keep fluid balance even in an ICU patient who may still be hypotensive. In the LIBERATE-D trial, the intervention a...

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Will you implement the conservative dialysis strategy from the LIBERATE-D trial for patients with dialysis-requiring acute kidney injury, or will you continue dialysis on a schedule until recovery based on creatinine and urine output?

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