Comparative evaluation of continuous renal replacement therapy and intermittent hemodialysis for the treatment of acute kidney injury

Acute kidney injury (AKI) remains a critical clinical condition with high morbidity and mortality. Continuous renal replacement therapy (CRRT) and intermittent hemodialysis (IHD) are commonly employed renal support modalities. This study aimed to compare the therapeutic efficacy and clinical outcomes of CRRT and IHD in patients with AKI. A retrospective cohort study was conducted at a single tertiary care center from January 2022 to December 2024. A total of 256 patients diagnosed with AKI were included, comprising 136 patients treated with CRRT and 120 with IHD. Patients were selected based on Kidney Disease: Improving Global Outcomes criteria, excluding those with stage 4 to 5 chronic kidney disease (CKD), prior renal transplantation, significant comorbidities, or concurrent enrollment in other clinical trials. Key outcome measures included changes in hemodynamic parameters (mean arterial pressure and heart rate), renal function markers (serum creatinine and blood urea nitrogen), and Acute Physiology and Chronic Health Evaluation II scores. Statistical analyses were performed using SPSS version 27.0 (IBM Corporation, Armonk), with independent t tests and Chi-square tests applied where appropriate. Following treatment, mean arterial pressure decreased slightly in the CRRT group, whereas a statistically significant greater reduction was observed in the IHD group (P < .05). Heart rate increased in both groups; however, the elevation was significantly more pronounced in the IHD group. Both modalities resulted in improved renal function and a significant reduction in Acute Physiology and Chronic Health Evaluation II scores. The incidence of treatment-related complications was comparatively lower in the CRRT group. Survival analysis indicated that survivors were significantly younger and exhibited a lower prevalence of multi-organ dysfunction. Compared to IHD, CRRT was associated with improved hemodynamic tolerance, lower complication rates, and potentially better short-term outcomes in patients with AKI. These findings support the preferential use of CRRT in critically ill patients with hemodynamic instability and warrant validation through prospective, multicenter studies.