Prospective randomized clinical trials indicate that the initial choice of intermittent versus continuous renal replacement therapy does not influence overall outcomes such as patient survival or recovery of kidney function. The decision for a therapy modality should be made based on the individual clinical situation of the patient, in particular taking into account hemodynamic stability, risk for bleeding, and patient mobility. The different treatment modalities should be regarded as complementary rather than being in competition, enabling a switch between modalities if the focus of therapy changes.