Dataset Information

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

ABSTRACT:

Rationale & objective

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.

Study design

Multicenter, prospective living registry.

Setting & population

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.

Exposure

CKRT for more than 24 hours.

Outcomes

Hospital mortality, kidney recovery, and health care resource utilization.

Analytical approach

Data were collected according to preselected timepoints at intensive care unit admission and CKRT initiation and analyzed descriptively.

Results

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, P < 0.001), had greater comorbidity (median Charlson score 3 [1-4] vs. 2 [1-3], P < 0.001), and higher acuity of illness (median APACHE-II score 30 [25-35] vs. 29 [24-33], P = 0.003). The most common condition predisposing to AKI was sepsis (42.6%), and the most common CKRT indications were oliguria/anuria (56.2%) and fluid overload (53.9%). Standardized mortality ratios were similar among centers.

Limitations

The generalizability of these results to CKRT practices in nonacademic centers or low-and middle-income countries is limited.

Conclusions

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.

SUBMITTER: Rewa OG

PROVIDER: S-EPMC10238597 | biostudies-literature | 2023 Jun

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

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

Rewa Oleksa G OG Ortiz-Soriano Victor V Lambert Joshua J Kabir Shaowli S Heung Michael M House Andrew A AA Monga Divya D Juncos Luis A LA Secic Michelle M Piazza Robin R Goldstein Stuart L SL Bagshaw Sean M SM Neyra Javier A JA

Kidney medicine 20230415 6

<h4>Rationale & objective</h4>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.<h4>Study design</h4>Multicenter, prospective living registry.<h4>Setting & population</h4>1,106 critically ill adults with AKI requiring CKRT from December 2013 to Ja ...[more]

PMID: 37274539

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Dataset Information

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

Rationale & objective

Study design

Setting & population

Exposure

Outcomes

Analytical approach

Results

Limitations

Conclusions

Publications

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

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