Comparison between sustained low-efficiencydialysis (SLED) and continuous renal replacement therapy (CRRT) in patients of septic shock: a randomized controlled trial

Methods Prospective randomized study in a 12 bedded medical ICU. After clearance from institutes ethics committee and taking informed consent from the relatives 40 adult patients in septic shock who were to undergo dialysis for Acute Kidney Injury were included in the study. They were randomly assigned to SLED or CRRT group. They underwent the same modality of dialysis until they were hemodynamically stable. Study was done with an Intention to treat. Hemodynamic instability was defined as an increase in vasopressor dependency > 20 mmHg-1 from the pre dialysis value. Vasopressor index was calculated by the formula (dopamine dose×1) + (dobutamine dose×1) + (adrenaline dose×100) + (noradrenaline dose×100) + (vasopressin dose×10).The doses were in microgram/kg/min for all vasopressors except vasopressin which is in Units/hour. The Vasopressor dependency was calculated by the formula (Vasopressor index/MAP) X 100. The worst value of vasopressor dependency during the dialysis session was taken into consideration. The primary objective was 28 day mortality. The secondary objective was hemodynamic stability during the dialysis sessions. The Statistical analysis was done by SPSS 17. Mann Whitney test was done for continuous data and Fishers Exact test was done for proportions. Survival analysis was done by Kaplan Mayer method with log rank test.