Low-efficiency acute renal replacement therapy: role in acute kidney injury.

The methodology, prescription, and delivery of acute renal replacement therapy are rapidly evolving areas. Recent clinical trials have provided clearer guidance around dosing targets for both therapy prescription and delivery. In this article, we discuss dialysis efficiency which is an area that subserves dialysis dose and pertains to manner in which a given dose is delivered. Dialysis efficiency directly effects the measurement and calculation of dose, and the occurrence of dialysis disequilibrium and hemodynamic instability. We provide recommendations around selecting the most appropriate clinical scenario and patients for higher-efficiency versus lower-efficiency therapy, and the implementation of therapy to achieve a given efficiency.