Epidemiology and Outcomes of AKI Treated With Continuous Kidney Replacement Therapy: The Multicenter CRRTnet Study.

AKI Acute kidney injury CKRT CRRT continuous kidney replacement therapy continuous renal replacement therapy epidemiology intensive care unit

Journal

Kidney medicine
ISSN: 2590-0595
Titre abrégé: Kidney Med
Pays: United States
ID NLM: 101756300

Informations de publication

Date de publication:
Jun 2023
Historique:
medline: 5 6 2023
pubmed: 5 6 2023
entrez: 5 6 2023
Statut: epublish

Résumé

Continuous kidney replacement therapy (CKRT) is the predominant form of acute kidney replacement therapy used for critically ill adult patients with acute kidney injury (AKI). Given the variability in CKRT practice, a contemporary understanding of its epidemiology is necessary to improve care delivery. Multicenter, prospective living registry. 1,106 critically ill adults with AKI requiring CKRT from December 2013 to January 2021 across 5 academic centers and 6 intensive care units. Patients with pre-existing kidney failure and those with coronavirus 2 infection were excluded. CKRT for more than 24 hours. Hospital mortality, kidney recovery, and health care resource utilization. Data were collected according to preselected timepoints at intensive care unit admission and CKRT initiation and analyzed descriptively. Patients' characteristics, contributors to AKI, and CKRT indications differed among centers. Mean (standard deviation) age was 59.3 (13.9) years, 39.7% of patients were women, and median [IQR] APACHE-II (acute physiologic assessment and chronic health evaluation) score was 30 [25-34]. Overall, 41.1% of patients survived to hospital discharge. Patients that died were older (mean age 61 vs. 56.8, The generalizability of these results to CKRT practices in nonacademic centers or low-and middle-income countries is limited. In this registry, sepsis was the major contributor to AKI and fluid management was collectively the most common CKRT indication. Significant heterogeneity in patient- and CKRT-specific characteristics was found in current practice. These data highlight the need for establishing benchmarks of CKRT delivery, performance, and patient outcomes. Data from this registry could assist with the design of such studies.

Identifiants

pubmed: 37274539
doi: 10.1016/j.xkme.2023.100641
pii: S2590-0595(23)00051-1
pmc: PMC10238597
doi:

Types de publication

Journal Article

Langues

eng

Pagination

100641

Informations de copyright

© 2023 The Authors.

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Auteurs

Oleksa G Rewa (OG)

Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, and Alberta Health Services, Edmonton Alberta Canada.

Victor Ortiz-Soriano (V)

Division of Nephrology, Bone and Mineral Metabolism, University of Kentucky, Lexington, KY.

Joshua Lambert (J)

College of Nursing, University of Cincinnati, Cincinnati, OH.

Shaowli Kabir (S)

Department of Biostatistics, University of Kentucky, Lexington, KY.

Michael Heung (M)

Division of Nephrology, University of Michigan, Ann Arbor, MI.

Andrew A House (AA)

Division of Nephrology, Western University and London Health Sciences Centre, London, Canada.

Divya Monga (D)

Division of Nephrology, University of Mississippi, Jackson, MI.

Luis A Juncos (LA)

Central Arkansas Veterans Healthcare System (CAVHS), Little Rock, Arkansas.
University of Arkansas for Medical Sciences, Little Rock, Arkansas.

Michelle Secic (M)

Secic Statistical Consulting, Chardon, OH.

Robin Piazza (R)

Watermark Research Partners, Inc, Indianapolis, IN.

Stuart L Goldstein (SL)

Center for Acute Care Nephrology, Cincinnati Children's Hospital and Medical Center, University of Cincinnati, Cincinnati, OH.

Sean M Bagshaw (SM)

Department of Critical Care Medicine, Faculty of Medicine and Dentistry, University of Alberta, and Alberta Health Services, Edmonton Alberta Canada.

Javier A Neyra (JA)

Division of Nephrology, Bone and Mineral Metabolism, University of Kentucky, Lexington, KY.
Department of Internal Medicine, Division of Nephrology, University of Alabama at Birmingham, Birmingham, AL.

Classifications MeSH