Epidemiology of continuous renal replacement therapy in Korea: Results from the National Health Insurance Service claims database from 2005 to 2016

Abstract

BackgroundContinuous renal replacement therapy (CRRT) is an important treatment modality for severe acute kidney injury. As such, the epidemiology of CRRT in Korea needs further investigation.MethodsWe conducted a nationwide, population-based study analyzing the claims data from National Health Insurance Service of Korea. All index intensive care unit admission cases of CRRT in government-designated tertiary referral hospitals in Korea from 2005 to 2016 were included. Patients with a history of renal replacement therapy or who were under 20 years old were not considered. In addition to baseline and treatment characteristics, patient outcomes, including all-cause mortality and renal survival rates, were investigated. We stratified the study patients according to 3-year time periods and major regions of the nation.ResultsWe included 37,337 patients who received CRRT in Korea. The overall use of CRRT increased over time, and more than 80% of cases of acute renal replacement therapy were CRRT after 2014. Seoul was the region in which the majority of CRRT (45.0%) was performed. The clinical characteristics of CRRT patients were significantly different among time-intervals and regions. Both all-cause mortality and renal survival rates after CRRT were prominently improved in the recent time periods (P < 0.001).ConclusionCRRT is a widely used treatment strategy for severe acute kidney injury in Korea. The prognosis of CRRT patients has improved compared to the past. This epidemiological study of CRRT in Korea revealed notable trends with regard to time period and geographic region.

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

“…With the aging of the population and increasing severity of comorbidities, the incidence of CRRT‐requiring AKI has significantly increased . The number of Korean patients who performed CRRT in the ICU has increased from 4667 in 2005 to 13 414 in 2016 . For severe AKI, the use of CRRT has also increased compared with intermittent RRT .…”

“…8 For severe AKI, the use of CRRT has also increased compared with intermittent RRT. 8 In parallel with these epidemiologic trends, various modifications in methodologic approaches have been developed, optimizing the intensity or timing of CRRT to improve survival. [9][10][11] Morbidity and mortality rates are still extremely high in this subset of patients, despite appropriate CRRT.…”

Long‐term impact of dialysis‐requiring AKI during the perioperative period of liver transplantation on postdischarge outcomes

“…13 In contrast, the incidence of MACE and ESRD among LT patients who survived after AKI-D was 3.41% and 12.81%, respectively, which was lower than that of total ICU survivors. Several factors could explain the similar long-term survival between the renal recovery group and the control group patients.…”

“…13 Between 2006 and 2015, all LT surgeries performed in 43 tertiary hospitals in Korea were selected. The NHIS collects insured medical services and claims data for all of Korea.…”

“…Along with the prevalence of AKI in patients awaiting LT, 7,8 hemodynamic instability, coagulation abnormality, electrolyte imbalance, and volume overload are also frequent complications during the perioperative period. 13 At the same time, overall patient survival after LT is also improving. 13 At the same time, overall patient survival after LT is also improving.…”