Renal replacement therapy , such as with hemodialysis , may be instituted in some cases of AKI. Renal replacement therapy can be applied intermittently (IRRT) and continuously (CRRT). Study results regarding differences in outcomes between IRRT and CRRT are inconsistent. A systematic review of the literature in 2008 demonstrated no difference in outcomes between the use of intermittent hemodialysis and continuous venovenous hemofiltration (CVVH) (a type of continuous hemodialysis).  Among critically ill patients, intensive renal replacement therapy with CVVH does not appear to improve outcomes compared to less intensive intermittent hemodialysis.   However, other studies demonstrated that compared with IRRT, initiation of CRRT is associated with a lower likelihood of chronic dialysis.  
Lactation studies have not been conducted with oral budesonide, including ENTOCORT EC, and no information is available on the effects of the drug on the breastfed infant or the effects of the drug on milk production. One published study reports that budesonide is present in human milk following maternal inhalation of budesonide [see Data ]. The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for ENTOCORT EC and any potential adverse effects on the breastfed infant from ENTOCORT EC, or from the underlying maternal condition.
The impact of successfully treating acute TCMR on graft outcomes has not been well studied. Greater histologic severity of acute TCMR (ie, Banff grade greater than IA) has been associated with lower response rates to therapy [ 4 ]. Higher histologic scores (eg, i: interstitial inflammation, t: tubulitis, v: intimal arteritis) and a later onset of rejection (>3 months posttransplant) have been associated with worse graft outcomes [ 5,6 ]. (See "Clinical features and diagnosis of acute renal allograft rejection", section on 'Acute T cell-mediated (cellular) rejection' .)