Continuous venovenous hemodiafiltration increased survival more than did continuous hemofiltration in acute renal failure.

M e t h o d s Design: Randomized controlled trial. Allocation: Concealed.* Blinding: Unblinded.* Follow-up period: 90 days. Setting: Intensive care units (ICUs) in Geneva, Switzerland. Patients: 206 patients (mean age 63 y, 61% men) with acute renal failure (urine output < 200 mL/12 h despite treatment or blood urea nitrogen > 30 mmol/L with urine output < 1500 mL/12 h). Exclusion criteria were prerenal or postrenal failure, suspicion of glomerular disease, end-stage renal failure, or use of angiotensin-converting enzyme inhibitors. Intervention: CVVHDF (ultrafiltration flow rate 25 mL/kg per h replacement fluid plus dialysate flow rate 1 to 1.5 L/h for body weight < or > 70 kg, respectively) (n = 104) or CVVH (ultrafiltration flow rate 25 mL/kg per h replacement fluid) (n = 102). All patients received heparin (or periodic flushing with saline when heparin was contraindicated). Outcomes: Survival at 28 and 90 days, renal recovery, and duration of ICU stay. Patient follow-up: 100% (intention-to-treat analysis).