Multicentre, open label, randomised, controlled trial of severe ARF management with an augmented vs normal CRRT regimen

突发性严重肾衰竭是重症监护患者经常发生的主要问题。对于这些患者，他们的生存机会大大降低。在澳大利亚，突发性严重肾衰竭通常需要肾机的持续肾支持来治疗。最近的一项研究发现，通过使用高于正常水平的肾脏支持，即通过肾脏机器运行更大体积的液体，重症监护病房（ICU）的患者可能不太可能死于突然严重的肾衰竭。尽管有这些积极的发现，这种高水平的肾脏支持在澳大利亚ICU并不常用。显然，如果高于正常水平的肾脏支持确实增加了个体生存的机会，那么患者应该接受这种治疗。澳大利亚和新西兰重症监护协会与乔治国际卫生研究所联合提议进行一项新的研究，涉及澳大利亚各地ICU的1500名患者，这些患者由于突然严重肾衰竭而需要持续的肾脏支持。这些患者将被随机分配，以便一半接受正常使用水平的肾脏支持，另一半接受高于正常水平的肾脏支持。然后将对患者进行为期三个月的随访，以比较每组患者的死亡比例。在整个研究过程中，将密切监测所有其他结果和严重副作用。研究结果将在研究开始后的四年内向公众公布，这些结果可能会影响澳大利亚乃至全世界ICU重症监护病房突发性严重肾衰竭患者的治疗。

Sudden serious kidney failure is a major problem that frequently occurs in patients who are in Intensive Care. For these patients, their chances of survival are significantly decreased. In Australia sudden serious kidney failure is usually treated with continuous kidney support by a kidney machine. A recent study found that by using greater than normal levels of kidney support, that is , running larger volumes of fluid through the kidney machine, patients in Intensive Care Units (ICU's) may be less likely to die from their sudden serious kidney failure. Despite these positive findings, this high level of kidney support is not commonly used in Australian ICU's. Clearly though, if greater than normal levels of kidney support do increase the chances that individuals will live, then patients should be receiving this treatment. The Australia and New Zealand Intensive Care Society, in conjunction with The George Institute for International Health, propose to conduct a new study involving 1500 patients from ICU's throughout Australia, who require continuous kidney support due to sudden serious kidney failure. These patients will be randomly assigned so that half receive the normally used levels of kidney support and the other half receive kidney support at greater than normal levels. Patients will then be followed for three months to compare the proportions of patients who die in each group. All other outcomes and serious side effects will be closely monitored throughout the study. The results will be available to the public within four years of starting the study, and these are likely to influence the treatment of patients admitted to ICU's with sudden serious kidney failure, not only in Australia but also worldwide.