Randomization
confusion, coin toss
This pragmatic trial was organized into 20 alternating 2-week blocks, which corresponded to the 2-week blocks in which UIHC renal fellows serve on the ICU rotation. This design was chosen to lessen delays or confusion related to decisions of modality initiation in this procedure, which is usually initiated on an emergency basis in critically-ill patients. Pre-filter CVVH was randomly selected by coin toss for block 1. For each two-week block of the trial, the nephrology consulting team would start the patient on either pre-filter CVVH or CVVHD according to the date of CKRT initiation. Once patients were assigned to a modality, they remained on that modality until their CKRT treatment was ended or until the Nephrology consult team felt a modality change was necessary based on clinical judgment. Due to an accidental block repeat of pre-filter CVVH (blocks 9 and 10), the trial ultimately ended with 11 blocks of pre-filter CVVH and 9 blocks of CVVHD. This trial was approved by the institutional review board at UIHC with a waiver of informed consent. The trial was registered at clinical trials.gov (NCT04762524), and this paper was constructed using the CONSORT guidelines for clinical trials.