{"doi":"10.1159/000506412","title":"Accelerated Venovenous Hemofiltration as a Transitional Renal Replacement Therapy in the Intensive Care Unit","abstract":"<jats:p>&lt;b&gt;&lt;i&gt;Background:&lt;/i&gt;&lt;/b&gt; Continuous renal replacement therapy (CRRT) is commonly employed in the intensive care unit (ICU), though there are no guidelines around the transition between CRRT and intermittent hemodialysis (iHD). Accelerated venovenous hemofiltration (AVVH) is a modality utilizing higher hemofiltration rates (4–5 L/h) with shorter session durations (8–10 h) to “accelerate” the clearance and volume removal that normally is spread out over a 24-h period in CRRT. We examined AVVH as a transition therapy between CRRT and iHD, with the aim of decreasing time on CRRT and providing a more graduated transition for hemodynamically unstable patients requiring RRT. &lt;b&gt;&lt;i&gt;Methods:&lt;/i&gt;&lt;/b&gt; Retrospective cohort study describing the clinical outcomes and quality initiative experience of the integration of AVVH into the CRRT program at an academic tertiary care center. Outcomes of interest included mortality, ICU length of stay and readmission rates, and technical characteristics of treatments. &lt;b&gt;&lt;i&gt;Results:&lt;/i&gt;&lt;/b&gt; In total, 97 patients received a total of 298 AVVH treatments (3.1 ± 3.3 treatments per patient). Totally, 271/298 (91%) treatments were completed successfully. During an average treatment time of 9.5 ± 1.6 h with 4.2 ± 0.5 L/h ­replacement fluid rate, urea reduction ratio was 23 ± 26% per 10-h treatment, and net ultrafiltration volume was 2.4 ± 1.3 L/treatment. Inpatient mortality was 32%, mean total hospital length of stay was 54 ± 47 days. Sixty-four out of 97 (66%) patients recovered renal function by discharge. Among those who transferred out of the ICU, 7/62 (11%) patients required readmission to the ICU after developing hypotension on iHD. &lt;b&gt;&lt;i&gt;Conclusion:&lt;/i&gt;&lt;/b&gt; AVVH can serve as a transition therapy between CRRT and iHD in the ICU and has the potential to decrease total time on CRRT, improve patient mobility, and sustain low ICU readmission rates. Future study is needed to analyze the implications on resource use and cost of this modality.</jats:p>","journal":"American Journal of Nephrology","year":2020,"id":653383,"datarank":0.4566783656585135,"base_score":3.044522437723423,"endowment":3.044522437723423,"self_citation_contribution":0.4566783656585135,"citation_network_contribution":0.0,"self_endowment_contribution":0.4566783656585135,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":20,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1263901,"name":"Paul Endres","orcid":"0000-0002-8574-1312","position":1,"is_corresponding":false},{"id":1704816,"name":"Tyler Parris","orcid":null,"position":2,"is_corresponding":false},{"id":1393027,"name":"Sophia Zhao","orcid":"0009-0002-5828-0706","position":3,"is_corresponding":false},{"id":1704817,"name":"Megan May","orcid":null,"position":4,"is_corresponding":false},{"id":1704818,"name":"Mary Sylvia-Reardon","orcid":null,"position":5,"is_corresponding":false},{"id":1704819,"name":"Nicole Bezreh","orcid":null,"position":6,"is_corresponding":false},{"id":1704820,"name":"Roberta Culbert-Costley","orcid":null,"position":7,"is_corresponding":false},{"id":1704821,"name":"Lillian Ananian","orcid":null,"position":8,"is_corresponding":false},{"id":1704822,"name":"Russel J. Roberts","orcid":null,"position":9,"is_corresponding":false},{"id":1395035,"name":"Natasha Lopez","orcid":"0000-0002-6646-8680","position":10,"is_corresponding":false},{"id":1704823,"name":"David M. Charytan","orcid":null,"position":11,"is_corresponding":false},{"id":861336,"name":"Nina Tolkoff-Rubin","orcid":null,"position":12,"is_corresponding":false},{"id":1704815,"name":"Andrew S. Allegretti","orcid":null,"position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Accelerated Venovenous Hemofiltration as a Transitional Renal Replacement Therapy in the Intensive Care Unit","abstract":"<jats:p>&lt;b&gt;&lt;i&gt;Background:&lt;/i&gt;&lt;/b&gt; Continuous renal replacement therapy (CRRT) is commonly employed in the intensive care unit (ICU), though there are no guidelines around the transition between CRRT and intermittent hemodialysis (iHD). Accelerated venovenous hemofiltration (AVVH) is a modality utilizing higher hemofiltration rates (4–5 L/h) with shorter session durations (8–10 h) to “accelerate” the clearance and volume removal that normally is spread out over a 24-h period in CRRT. We examined AVVH as a transition therapy between CRRT and iHD, with the aim of decreasing time on CRRT and providing a more graduated transition for hemodynamically unstable patients requiring RRT. &lt;b&gt;&lt;i&gt;Methods:&lt;/i&gt;&lt;/b&gt; Retrospective cohort study describing the clinical outcomes and quality initiative experience of the integration of AVVH into the CRRT program at an academic tertiary care center. Outcomes of interest included mortality, ICU length of stay and readmission rates, and technical characteristics of treatments. &lt;b&gt;&lt;i&gt;Results:&lt;/i&gt;&lt;/b&gt; In total, 97 patients received a total of 298 AVVH treatments (3.1 ± 3.3 treatments per patient). Totally, 271/298 (91%) treatments were completed successfully. During an average treatment time of 9.5 ± 1.6 h with 4.2 ± 0.5 L/h ­replacement fluid rate, urea reduction ratio was 23 ± 26% per 10-h treatment, and net ultrafiltration volume was 2.4 ± 1.3 L/treatment. Inpatient mortality was 32%, mean total hospital length of stay was 54 ± 47 days. Sixty-four out of 97 (66%) patients recovered renal function by discharge. Among those who transferred out of the ICU, 7/62 (11%) patients required readmission to the ICU after developing hypotension on iHD. &lt;b&gt;&lt;i&gt;Conclusion:&lt;/i&gt;&lt;/b&gt; AVVH can serve as a transition therapy between CRRT and iHD in the ICU and has the potential to decrease total time on CRRT, improve patient mobility, and sustain low ICU readmission rates. Future study is needed to analyze the implications on resource use and cost of this modality.</jats:p>","is_dataset_classified":null,"base_score":3.044522437723423,"endowment":3.044522437723423,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"32097936","pmcid":null,"openalex_id":"https://openalex.org/W3007642848","authors":[],"funders":[],"total_grants":0,"fwci":1.8897,"citation_percentile":0.85784023,"influential_citations":0,"citation_trend":[{"year":2020,"count":7},{"year":2021,"count":2},{"year":2022,"count":2},{"year":2023,"count":4},{"year":2024,"count":1},{"year":2025,"count":1},{"year":2026,"count":3}],"oa_status":"closed","license":"https://www.karger.com/Services/SiteLicenses","oa_locations":[{"url":"https://www.karger.com/Article/Pdf/506412","host_type":"publisher"},{"url":"https://doi.org/10.1159/000506412","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/32097936","host_type":"repository"}],"fields_of_study":["Acute Kidney Injury Research","Dialysis and Renal Disease Management","Central Venous Catheters and Hemodialysis","Acute Kidney Injury","Adult","Aged","Continuous Renal Replacement Therapy","Female","Hospital Mortality","Humans","Intensive Care Units","Intermittent Renal Replacement Therapy","Kidney Failure, Chronic","Length of Stay","Male","Middle Aged","Patient Readmission","Retrospective Studies","Treatment Outcome"],"mesh_terms":["Continuous Renal Replacement Therapy","Intermittent Renal Replacement Therapy","Adult","Aged","Female","Humans","Intensive Care Units","Kidney Failure, Chronic","Length of Stay","Male","Middle Aged","Patient Readmission","Retrospective Studies","Treatment Outcome","Hospital Mortality","Acute Kidney Injury"],"keywords":["Renal replacement therapy","Medicine","Hemofiltration","Intensive care unit","Hemodialysis","Retrospective cohort study","Internal medicine","Acute Kidney Injury","End-stage Renal Disease","Continuous Renal Replacement Therapy","Prolonged, Intermittent Renal Replacement Therapy"],"sdg_mappings":[{"sdg_number":0,"sdg_label":"Good health and well-being"}],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-10T21:17:04.865486Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}