How acute kidney injury is investigated and managed in UK intensive care units--a survey of current practice

Jones, Sarah L.; Devonald, Mark A.J.

doi:10.1093/ndt/gft015

Cited by 51 publications

(43 citation statements)

References 21 publications

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“…For example, in the DOREMI study, a multicenter observational study conducted mainly in Italy from 2005 to 2007, the median CRRT dose was 34.3 mL kg -1 h -1 [11]. Another survey conducted in the UK in 2009 and 2010 revealed that the most common standard dose of CVVH prescribed in ICUs was 35 mL kg -1 h -1 [12]. In an international survey for RRT in the ICU, in which 80% of respondents were from Europe, the average ultrafiltration dose was 35 mL kg -1 h -1 , while for septic patients it was also 35 mL kg -1 h -1 [13].…”

Section: Movement To Higher Crrt Hemofiltration Ratementioning

confidence: 99%

Validity of low-efficacy continuous renal replacement therapy in critically ill patients

Kawarazaki¹,

Uchino

2016

Anaesthesiol Intensive Ther

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The 1980s saw the use of continuous arteriovenous hemofiltration whose intensity hemofiltration rate was only 3 or 4 mL kg -1 h -1 . With the installation of a blood pump, this dose went up to 8 or 10 mL kg -1 h -1 , and continued to increase, reaching about 20 mL kg -1 h -1 by the year 2000. Some studies found that a higher dose could be beneficial, and the world rapidly followed the trend, increasing the dose up to 35 mL kg -1 h -1 . Then, two randomized control trials, namely the VA/NIH Acute Renal Failure Trial Network study and the RENAL study, came along in succession which changed the Kidney Disease: Improving Global Outcomes (KDIGO) recommendation to 20 to 25 mL kg -1 h -1 . However, no good evidence exists to support this. Our recent multicenter retrospective studies from the JSEPTIC CRRT database show that the Japanese continuous renal replacement therapy dose of (14.3 mL kg -1 h -1 ) does not seem to have worse outcomes when compared with a higher dose.

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Section: Movement To Higher Crrt Hemofiltration Ratementioning

confidence: 99%

Validity of low-efficacy continuous renal replacement therapy in critically ill patients

Kawarazaki¹,

Uchino

2016

Anaesthesiol Intensive Ther

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“…The two most commonly used techniques lie at opposite ends of the spectra [11]. Peritoneal dialysis (PD) is rarely used to treat AKI in developed countries where extracorporeal RRT methods are widely available, but is sometimes used in children and occasionally in adults where there are significant problems with vascular access or haemodynamic stability.…”

Section: Renal Replacement Therapy In Akimentioning

confidence: 99%

Micronutrient and amino acid losses in acute renal replacement therapy

Gardner

Devonald

2015

Current Opinion in Clinical Nutrition and Metabolic Care

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Purpose of reviewA wide range of renal replacement therapies is now available to support patients with acute kidney injury. These treatments utilize diffusion, convection or a combination of these mechanisms to remove metabolic waste products from the bloodstream. It is inevitable that physiologically important substances including micronutrients will also be removed. Here we review current knowledge of the extent of micronutrient loss, how it varies between treatment modalities and its clinical significance. Recent findingsVery few studies have specifically investigated micronutrient loss in renal replacement therapy for acute kidney injury. Recent data suggest that trace elements and amino acids are lost during intermittent dialysis, hybrid therapies such as sustained low efficiency diafiltration and continuous therapies. Extent of micronutrient loss appears to vary with treatment type, with continuous convection based treatments probably causing greatest losses. SummaryPatients with acute kidney injury are at high risk of disease related malnutrition. The use of renal replacement therapy, while often essential for life support, results in loss of micronutrients into the filtrate or dialysate. Losses are probably greater with continuous convective treatments, but it is not yet known whether these losses are clinically significant or whether their replacement would improve patient outcomes.

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“…Plusieurs recommandations d'experts et expériences d'équipes s'accordent pour dire que la gestion des séances d'EER par un personnel formé et fondée sur des procédures est nécessaire [168,169,[173][174][175][176][177]. Dans une enquête récente sur la prise en charge de l'IRA menée dans 188 réanimations au Royaume-Uni, 73 % des services déclaraient, effectivement, disposer d'une procé-dure standardisée pour la réalisation de l'EER [178]. Les risques infectieux liés à la pratique de l'EER sont multiples.…”

Section: Les éQuipes Médicales Et Paramédicales Doivent êTre Forméesunclassified

Épuration extrarénale en réanimation adulte et pédiatrique. Recommandations formalisées d’experts sous l’égide de la Société de réanimation de langue française (SRLF), avec la participation de la Société française d’anesthésie-réanimation (Sfar), du Groupe francophone de réanimation et urgences pédiatriques (GFRUP) et de la Société francophone de dialyse (SFD)

et al. 2014

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How acute kidney injury is investigated and managed in UK intensive care units--a survey of current practice

Abstract: Considerable variation exists in the investigation and management of AKI in UK ICUs. Despite increasing recognition of the importance of AKI, few ICUs are aware of RIFLE and AKIN criteria.

Cited by 51 publications

References 21 publications

Validity of low-efficacy continuous renal replacement therapy in critically ill patients

Validity of low-efficacy continuous renal replacement therapy in critically ill patients

Micronutrient and amino acid losses in acute renal replacement therapy

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