Renal Replacement Therapy Modality in the ICU and Renal Recovery at Hospital Discharge*

Bonnassieux, Martin; Duclos, Antoine; Schneider, Antoine; Schmidt, Aurélie; Bénard, S.; Cancalon, Charlotte; Joannès-Boyau, Olivier; Ichai, Carole; Constantin, Jean-Michel; Lefrant, Jean‐Yves; Kellum, John A.; Rimmelé, Thomas

doi:10.1097/ccm.0000000000002796

Cited by 51 publications

(40 citation statements)

References 40 publications

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“…Table indicated the characteristics of all included studies. Lastly, the study included 11 articles for comparison between AKI patients treated with CRRT and IHD, 10‐12,14‐21 eight articles for comparison between AKI patients treated with CRRT and SLED, 8,9,22‐26 and three articles 27‐29 for comparison between AKI patients treated with CRRT and IRRT (which kind of IRRT was not clear), respectively. For comparison between AKI patients treated with CRRT and IHD, these studies included totally 42 079 AKI patients given CRRT and 19 154 patients given IHD.…”

Section: Resultsmentioning

confidence: 99%

“…Bonnassieux et al showed lower renal recovery and higher in‐ICU mortality in AKI patients treated with CRRT, compared to those treated with IHD 20 . AKI patients treated with CRRT showed a higher rate of baseline vasopressor use compared to AKI patients treated with IHD 20 . The study is a RCT study with large cohort (40 905 AKI patients treated with CRRT vs 17 730 AKI patients treated with IHD) 20 .…”

Section: Discussionmentioning

confidence: 96%

“…The study did not report details in baseline serum creatinine, numbers of patients experienced hypotension, and vasopressor use 19 . Bonnassieux et al showed lower renal recovery and higher in‐ICU mortality in AKI patients treated with CRRT, compared to those treated with IHD 20 . AKI patients treated with CRRT showed a higher rate of baseline vasopressor use compared to AKI patients treated with IHD 20 .…”

Section: Discussionmentioning

confidence: 99%

“…AKI patients treated with CRRT showed a higher rate of baseline vasopressor use compared to AKI patients treated with IHD 20 . The study is a RCT study with large cohort (40 905 AKI patients treated with CRRT vs 17 730 AKI patients treated with IHD) 20 . However, the study did not report baseline serum creatinine and numbers of patients experienced hypotension 20 .…”

Section: Discussionmentioning

confidence: 99%

“…The study is a RCT study with large cohort (40 905 AKI patients treated with CRRT vs 17 730 AKI patients treated with IHD) 20 . However, the study did not report baseline serum creatinine and numbers of patients experienced hypotension 20 . Indeed, more rigorous trials design should had been made.…”

Section: Discussionmentioning

confidence: 99%

See 4 more Smart Citations

Effect of renal replacement therapy modalities on renal recovery and mortality for acute kidney injury: A PRISMA‐compliant systematic review and meta‐analysis

Zhao

Chen

2020

Seminars in Dialysis

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Previous investigations showed inconsistent results for comparison in renal recovery, in‐hospital, and in‐intensive care unit (ICU) mortalities between acute kidney injury (AKI) patients treated with continuous renal replacement therapy (CRRT) and some kinds of intermittent renal replacement therapies (IRRTs). We systematically searched for articles published in the databases (PubMed, Web of Science, EMBASE, Medline, and Google Scholar) until June 2019. We made all statistical analysis using STATA 12.0 software. In the present meta‐analysis, relative risks with 95% confidence intervals were calculated for binary outcomes (renal recovery status or mortality). The present study indicated no significant differences in renal recovery, in‐hospital mortality, and in‐ICU mortality between AKI patients given CRRT and those given sustained low‐efficiency dialysis (SLED). Additionally, the study showed no significant difference in in‐hospital mortality between AKI patients given CRRT and those given intermittent hemodialysis (IHD), whereas elevated in‐ICU mortality was detected in AKI patients given CRRT, compared to those given IHD. The three modalities (CRRT, IHD, and SLED) have their own advantages and disadvantages. More rigorous trials design with large cohort should be made to explore the differences in renal recovery, in‐hospital, and in‐ICU mortalities between different kinds of RRTs.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Effect of renal replacement therapy modalities on renal recovery and mortality for acute kidney injury: A PRISMA‐compliant systematic review and meta‐analysis

Zhao

Chen

2020

Seminars in Dialysis

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Practical considerations for individualizing drug dosing in critically ill adults receiving renal replacement therapy

et al. 2023

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Critically ill patients with sepsis admitted to the intensive care unit (ICU) often present with or develop renal dysfunction requiring renal replacement therapy (RRT) in addition to antimicrobial therapy. While early and appropriate antimicrobials for sepsis have been associated with an increased probability of survival, adequate dosing is also required in these patients. Adequate dosing of antimicrobials refers to dosing strategies that achieve serum drug levels at the site of infection that are able to provide a microbiological and/or clinical response while avoiding toxicity from excessive antibiotic exposure. Therapeutic drug monitoring (TDM) is the recommended strategy to achieve this goal, however, TDM is not routinely available in all ICUs and for all antimicrobials. In the absence of TDM, clinicians are therefore required to make dosing decisions based on the clinical condition of the patient, the causative organism, the characteristics of RRT, and an understanding of the physicochemical properties of the antimicrobial. Pharmacokinetics (PK) of antimicrobials can be highly variable between critically ill patients and also within the same patient over the course of their ICU stay. The initiation of RRT, which can be in the form of intermittent hemodialysis, continuous, or prolonged intermittent therapy, further complicates the predictability of drug disposition. This variability highlights the need for individualized dosing. This review highlights the practical considerations for the clinician for antimicrobial dosing in critically ill patients receiving RRT.

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Sepsis and Acute Kidney Injury: Epidemiology, Pathophysiology, Diagnosis, and Management

Alobaidi

Bagshaw

2018

Core Concepts in Acute Kidney Injury

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Renal Replacement Therapy Modality in the ICU and Renal Recovery at Hospital Discharge*

Abstract: In this large retrospective study, intermittent hemodialysis as an initial modality was associated with lower renal recovery at hospital discharge among patients with acute kidney injury, although the difference seems somewhat clinically limited.

Cited by 51 publications

References 40 publications

Effect of renal replacement therapy modalities on renal recovery and mortality for acute kidney injury: A PRISMA‐compliant systematic review and meta‐analysis

Effect of renal replacement therapy modalities on renal recovery and mortality for acute kidney injury: A PRISMA‐compliant systematic review and meta‐analysis

Practical considerations for individualizing drug dosing in critically ill adults receiving renal replacement therapy

Sepsis and Acute Kidney Injury: Epidemiology, Pathophysiology, Diagnosis, and Management

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