Intensity of continuous renal replacement therapy for acute kidney injury

Fayad, Alicia; Buamscha, Daniel; Ciapponi, Agustín

doi:10.1002/14651858.cd010613

Cited by 19 publications

(15 citation statements)

References 38 publications

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“…16 The relationship between CRRT and patients' outcome varied in patients with the different disease and was effected by the modalities, anticoagulation, vascular access management, timing of initiation and intensity of CRRT. 17,20,21 To date, no specific treatment has been confirmed to be effective for COVID-19, and supportive treatment remains essential. As far as we know, the effect of CRRT on critically ill patients with COVID-19 has not been reported.…”

mentioning

confidence: 99%

Association between Prolonged Intermittent Renal Replacement Therapy and All-Cause Mortality in COVID-19 Patients Undergoing Invasive Mechanical Ventilation: a Retrospective Cohort Study

Yang

Shi

et al. 2020

Preprint

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mentioning

confidence: 99%

Association between Prolonged Intermittent Renal Replacement Therapy and All-Cause Mortality in COVID-19 Patients Undergoing Invasive Mechanical Ventilation: a Retrospective Cohort Study

Yang

Shi

et al. 2020

Preprint

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“…For severe AKI, the use of CRRT has also increased compared with intermittent RRT . In parallel with these epidemiologic trends, various modifications in methodologic approaches have been developed, optimizing the intensity or timing of CRRT to improve survival . Morbidity and mortality rates are still extremely high in this subset of patients, despite appropriate CRRT .…”

mentioning

confidence: 99%

Development of a new mortality scoring system for acute kidney injury with continuous renal replacement therapy

et al. 2019

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Aim On the basis of the worst outcomes of patients undergoing continuous renal replacement therapy (CRRT) in intensive care unit, previously developed mortality prediction model, Acute Physiologic Assessment and Chronic Health Evaluation II (APACHE II) and the Sequential Organ Failure Assessment (SOFA) needs to be modified. Methods A total of 828 patients who underwent CRRT were recruited. Mortality prediction model was developed for the prediction of death within 7 days after starting the CRRT. Based on regression analysis, modified scores were assigned to each variable which were originally used in the APACHE II and SOFA scoring models. Additionally, a new abbreviated Mortality Scoring system for AKI with CRRT (MOSAIC) was developed after stepwise selection analysis. Results We used all the variables included in the APACHE II and SOFA scoring models. The prediction powers indicated by C‐statistics were 0.686 and 0.683 for 7‐day mortality by the APACHE II and SOFA systems, respectively. After modification of these models, the prediction powers increased up to 0.752 for the APACHE II and 0.724 for the SOFA systems. Using multivariate analysis, seven significant variables were selected in the MOSAIC model wherein its C‐statistic value was 0.772. These models also showed good performance with 0.720, 0.734 and 0.773 of C‐statistics in the modified APACHE II, modified SOFA and MOSAIC scoring models in the external validation cohort (n = 497). Conclusion The modified APACHE II/SOFA and newly developed MOSAIC models could be more useful tool for predicting mortality for patients receiving CRRT.

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“…The conclusions of these 2 large interventional studies were further supported by a 2016 Cochrane systematic review stating that higher dose of CRRT does not impact favorably on mortality or recovery of kidney function in critically ill patients with AKI and increases the risk of hypophosphatemia [45]. Two additional metanalyse concluded that higher intensity RRT does not impact mortality outcome [46, 47].…”

Section: Interventional Studies Examining Crrt Dose In Heterogeneous mentioning

confidence: 99%

Dose of Continuous Renal Replacement Therapy in Critically Ill Patients: A Bona Fide Quality Indicator

Vásquez-Jiménez

Anumudu

Neyra

2021

Nephron

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Acute kidney injury (AKI) is common in critically ill patients, and renal replacement therapy (RRT) constitutes an important aspect of acute management during critical illness. Continuous RRT (CRRT) is frequently utilized in intensive care unit settings, particularly in patients with severe AKI, fluid overload, and hemodynamic instability. The main goal of CRRT is to timely optimize solute control, acid-base, and volume status. Total effluent dose of CRRT is a deliverable that depends on multiple factors and therefore should be systematically monitored (prescribed vs. delivered) and iteratively adjusted in a sustainable mode. In this manuscript, we review current evidence of CRRT dosing and provide recommendations for its implementation as a quality indicator of CRRT delivery.

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Intensity of continuous renal replacement therapy for acute kidney injury

Cited by 19 publications

References 38 publications

Association between Prolonged Intermittent Renal Replacement Therapy and All-Cause Mortality in COVID-19 Patients Undergoing Invasive Mechanical Ventilation: a Retrospective Cohort Study

Association between Prolonged Intermittent Renal Replacement Therapy and All-Cause Mortality in COVID-19 Patients Undergoing Invasive Mechanical Ventilation: a Retrospective Cohort Study

Development of a new mortality scoring system for acute kidney injury with continuous renal replacement therapy

Dose of Continuous Renal Replacement Therapy in Critically Ill Patients: A Bona Fide Quality Indicator

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