BTK was involved in editing and revising. DJB was involved in study conception and revising. JAJ was involved in statistical analysis www.selleckchem.com/products/AZD2281(Olaparib).html and manuscript drafting. LCC was involved in study conception and revising. LHB was involved in editing and final approval of the manuscript. SEW was involved in study conception, data analysis, manuscript editing and supervision of the research group.Authors’ informationKKC (medical intensivist) is the Medical Director of the burn ICU. He is also the Director of the CVVH program. JBL, BTK, CEW, DJB, and LCC are burn/trauma surgeons. JRM is a pediatric nephrologist and president and CEO of Immunocept LLC. SEW (burn surgeon) is the former Burn Director of the US Army Burn Center and current director of research. He is also the Editor-in-Chief of Burns.

EMR is a burn/trauma surgeon and also the current director of the US Army Burn Center. LHB is the commander of the US Army Institute of Surgical Research.AcknowledgementsThe authors would like to thank the dedicated ICU nursing staff whom without their enthusiastic support and advocacy, the CVVH program would not exist. The views expressed herein are those of the authors and do not necessarily reflect those of the Army Medical Department or the Department of Defense.
Acute kidney injury (AKI) requiring renal replacement therapy (RRT) occurs in 5 to 6% of critically ill patients and is associated with high mortality and significant health resource utilization [1-3]. Controversy exists as to what constitutes optimal RRT in this setting.

There are several modifiable factors in the delivery of RRT which may potentially influence patient outcome, including RRT modality (continuous or intermittent), solute removal mechanisms (convection, diffusion, adsorption or combination), timing of initiation and dose of treatment. The relationship between patient outcome and treatment dose was first introduced in a landmark study where patients randomised to post-dilution continuous veno-venous haemofiltration (CVVH) at a dose of 35 ml/kg/hour or above had improved survival compared with those randomised to 20 ml/kg/hour [4]. Since then, this issue has been explored in other studies with conflicting results [5-9]. The Acute Dialysis Quality Initiative recommends a higher dose in the absence of definitive data, particularly in septic patients [10,11].

However, practice surveys suggest that this threshold dose has not been widely adopted into current intensive care units (ICU) practice [12,13].We performed a prospective European multicentre observational cohort study to evaluate the prescription GSK-3 and actual-delivered RRT dose in ICUs and its relationship with patient outcome, such as mortality and duration of mechanical ventilation and ICU stay. Our hypothesis was that a higher RRT dose would be associated with better patient outcomes.