Clinical and economic impact of a switch from high‐ to low‐volume renal replacement therapy in patients with acute kidney injury

High‐intensity renal replacement therapy protocols in intensive care patients with acute kidney injury have failed to translate to improved patient outcomes when compared with lower‐intensity protocols. This retrospective study explored the clinical and economic impacts of switching from a 30–35 ml.kg^?1.h^?1 (high‐volume) to a 20 ml.kg^?1.h^?1 (low‐volume) protocol. Patients (n = 366) admitted 12 months before (n = 187) and after (n = 179) the switch were included in the study. There was no difference in in‐hospital mortality (77/187 (41%) vs 75/179 (42%), respectively, p = 0.92), intensive care unit mortality (55/187 (29%) vs 61/179 (34%), respectively, p = 0.40), duration of organ support or extent of renal recovery between the high‐ and low‐volume cohorts. A 25% reduction in daily replacement fluid usage was observed, equating to a cost saving of over £27 000 per annum. In conclusion, a switch from high‐ to low‐volume continuous haemodiafiltration had minimal effects on clinical outcomes and resulted in marked cost savings.