Delivered dose of renal replacement therapy and mortality in critically ill patients with acute kidney injury
The optimal dialysis dose for the treatment of acute kidney injury (AKI) is controversial. We sought to evaluate the relationship between renal replacement therapy (RRT) dose and outcome. We performed a prospective multicentre observational study in 30 intensive care units (ICUs) in eight countries...
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| creator | Vesconi, Sergio Cruz, Dinna N Fumagalli, Roberto Kindgen-Milles, Detlef Monti, Gianpaola Marinho, Anibal Mariano, Filippo Formica, Marco Marchesi, Mariano René, Robert Livigni, Sergio Ronco, Claudio |
| description | The optimal dialysis dose for the treatment of acute kidney injury (AKI) is controversial. We sought to evaluate the relationship between renal replacement therapy (RRT) dose and outcome.
We performed a prospective multicentre observational study in 30 intensive care units (ICUs) in eight countries from June 2005 to December 2007. Delivered RRT dose was calculated in patients treated exclusively with either continuous RRT (CRRT) or intermittent RRT (IRRT) during their ICU stay. Dose was categorised into more-intensive (CRRT >or= 35 ml/kg/hour, IRRT >or= 6 sessions/week) or less-intensive (CRRT < 35 ml/kg/hour, IRRT < 6 sessions/week). The main outcome measures were ICU mortality, ICU length of stay and duration of mechanical ventilation.
Of 15,200 critically ill patients admitted during the study period, 553 AKI patients were treated with RRT, including 338 who received CRRT only and 87 who received IRRT only. For CRRT, the median delivered dose was 27.1 ml/kg/hour (interquartile range (IQR) = 22.1 to 33.9). For IRRT, the median dose was 7 sessions/week (IQR = 5 to 7). Only 22% of CRRT patients and 64% of IRRT patients received a more-intensive dose. Crude ICU mortality among CRRT patients were 60.8% vs. 52.5% (more-intensive vs. less-intensive groups, respectively). In IRRT, this was 23.6 vs. 19.4%, respectively. On multivariable analysis, there was no significant association between RRT dose and ICU mortality (Odds ratio (OR) more-intensive vs. less-intensive: CRRT OR = 1.21, 95% confidence interval (CI) = 0.66 to 2.21; IRRT OR = 1.50, 95% CI = 0.48 to 4.67). Among survivors, shorter ICU stay and duration of mechanical ventilation were observed in the more-intensive RRT groups (more-intensive vs. less-intensive for all: CRRT (median): 15 (IQR = 8 to 26) vs. 19.5 (IQR = 12 to 33.5) ICU days, P = 0.063; 7 (IQR = 4 to 17) vs. 14 (IQR = 5 to 24) ventilation days, P = 0.031; IRRT: 8 (IQR = 5.5 to 14) vs. 18 (IQR = 13 to 35) ICU days, P = 0.008; 2.5 (IQR = 0 to 10) vs. 12 (IQR = 3 to 24) ventilation days, P = 0.026).
After adjustment for multiple variables, these data provide no evidence for a survival benefit afforded by higher dose RRT. However, more-intensive RRT was associated with a favourable effect on ICU stay and duration of mechanical ventilation among survivors. This result warrants further exploration.
Cochrane Renal Group (CRG110600093). |
| doi_str_mv | 10.1186/cc7784 |
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| fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_2689504</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A199550828</galeid><sourcerecordid>A199550828</sourcerecordid><originalsourceid>FETCH-LOGICAL-b480t-53b50057b3996496e261d2c1a0cb60ec7be0d2835a23bc91e9ea6bb07b09504f3</originalsourceid><addsrcrecordid>eNp1kk1v1DAQhi0Eou0CPwFZHLil2HHs2BekqrQFqVIvReJm2c6k68WJg-MU7b_Hq6woPSBL_pp3npnxGKF3lJxTKsUn59pWNi_QKW2EqARRP16WPRNNJTnjJ-hsnneE0FYK9hqdUMWEbOvmFA1fIPhHSNDhLs6AY48TjCaUeQrGwQBjxnkLyUx7bMYODzFlE3zeYz9il3z2zoRQTiHgyWRf9DP-7fMWG7dkwD99N8JBvFvS_g161Zsww9vjukHfr6_uL79Wt3c33y4vbivbSJIrziwnhLeWKSUaJaAWtKsdNcRZQcC1FkhXS8ZNzaxTFBQYYS1pLVGcND3boM8rd1rsAJ0rSSUT9JT8YNJeR-P1c8vot_ohPupayAOhANQKsD7-B_Dc4uKg1x4U3w_H4Cn-WmDOeheXVN501lTxRhDZ8CI6X0UPJoD2Yx8LxpXRweBdHKH35f6CKsU5kaXWDfq4OrgU5zlB_zcZSvThCzyFf_9v7U-yY8_ZH6FMr7k</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>195460845</pqid></control><display><type>article</type><title>Delivered dose of renal replacement therapy and mortality in critically ill patients with acute kidney injury</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><source>DOAJ Directory of Open Access Journals</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><source>Alma/SFX Local Collection</source><source>Springer Nature OA Free Journals</source><creator>Vesconi, Sergio ; Cruz, Dinna N ; Fumagalli, Roberto ; Kindgen-Milles, Detlef ; Monti, Gianpaola ; Marinho, Anibal ; Mariano, Filippo ; Formica, Marco ; Marchesi, Mariano ; René, Robert ; Livigni, Sergio ; Ronco, Claudio</creator><creatorcontrib>Vesconi, Sergio ; Cruz, Dinna N ; Fumagalli, Roberto ; Kindgen-Milles, Detlef ; Monti, Gianpaola ; Marinho, Anibal ; Mariano, Filippo ; Formica, Marco ; Marchesi, Mariano ; René, Robert ; Livigni, Sergio ; Ronco, Claudio ; DOse REsponse Multicentre International collaborative Initiative (DO-RE-MI Study Group) ; the DOse REsponse Multicentre International collaborative Initiative (DO-RE-MI Study Group)</creatorcontrib><description>The optimal dialysis dose for the treatment of acute kidney injury (AKI) is controversial. We sought to evaluate the relationship between renal replacement therapy (RRT) dose and outcome.
We performed a prospective multicentre observational study in 30 intensive care units (ICUs) in eight countries from June 2005 to December 2007. Delivered RRT dose was calculated in patients treated exclusively with either continuous RRT (CRRT) or intermittent RRT (IRRT) during their ICU stay. Dose was categorised into more-intensive (CRRT >or= 35 ml/kg/hour, IRRT >or= 6 sessions/week) or less-intensive (CRRT < 35 ml/kg/hour, IRRT < 6 sessions/week). The main outcome measures were ICU mortality, ICU length of stay and duration of mechanical ventilation.
Of 15,200 critically ill patients admitted during the study period, 553 AKI patients were treated with RRT, including 338 who received CRRT only and 87 who received IRRT only. For CRRT, the median delivered dose was 27.1 ml/kg/hour (interquartile range (IQR) = 22.1 to 33.9). For IRRT, the median dose was 7 sessions/week (IQR = 5 to 7). Only 22% of CRRT patients and 64% of IRRT patients received a more-intensive dose. Crude ICU mortality among CRRT patients were 60.8% vs. 52.5% (more-intensive vs. less-intensive groups, respectively). In IRRT, this was 23.6 vs. 19.4%, respectively. On multivariable analysis, there was no significant association between RRT dose and ICU mortality (Odds ratio (OR) more-intensive vs. less-intensive: CRRT OR = 1.21, 95% confidence interval (CI) = 0.66 to 2.21; IRRT OR = 1.50, 95% CI = 0.48 to 4.67). Among survivors, shorter ICU stay and duration of mechanical ventilation were observed in the more-intensive RRT groups (more-intensive vs. less-intensive for all: CRRT (median): 15 (IQR = 8 to 26) vs. 19.5 (IQR = 12 to 33.5) ICU days, P = 0.063; 7 (IQR = 4 to 17) vs. 14 (IQR = 5 to 24) ventilation days, P = 0.031; IRRT: 8 (IQR = 5.5 to 14) vs. 18 (IQR = 13 to 35) ICU days, P = 0.008; 2.5 (IQR = 0 to 10) vs. 12 (IQR = 3 to 24) ventilation days, P = 0.026).
After adjustment for multiple variables, these data provide no evidence for a survival benefit afforded by higher dose RRT. However, more-intensive RRT was associated with a favourable effect on ICU stay and duration of mechanical ventilation among survivors. This result warrants further exploration.
Cochrane Renal Group (CRG110600093).</description><identifier>ISSN: 1364-8535</identifier><identifier>EISSN: 1466-609X</identifier><identifier>EISSN: 1364-8535</identifier><identifier>DOI: 10.1186/cc7784</identifier><identifier>PMID: 19368724</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>Acute Kidney Injury - mortality ; Acute Kidney Injury - therapy ; Acute renal failure ; Adult ; Aged ; Care and treatment ; Critical Illness ; Critically ill ; Demographic aspects ; Dialysis Solutions - administration & dosage ; Dose-Response Relationship, Drug ; Endpoint Determination ; Female ; Humans ; Intensive Care Units ; Male ; Methods ; Middle Aged ; Mortality ; Outcome Assessment, Health Care ; Patient outcomes ; Prognosis ; Prospective Studies ; Renal Replacement Therapy - methods</subject><ispartof>Critical care (London, England), 2009-01, Vol.13 (2), p.R57-R57, Article R57</ispartof><rights>COPYRIGHT 2009 BioMed Central Ltd.</rights><rights>Copyright National Library of Medicine - MEDLINE Abstracts 2009</rights><rights>Copyright © 2009 Vesconi et al.; licensee BioMed Central Ltd. 2009 Vesconi et al.; licensee BioMed Central Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b480t-53b50057b3996496e261d2c1a0cb60ec7be0d2835a23bc91e9ea6bb07b09504f3</citedby><cites>FETCH-LOGICAL-b480t-53b50057b3996496e261d2c1a0cb60ec7be0d2835a23bc91e9ea6bb07b09504f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2689504/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2689504/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19368724$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Vesconi, Sergio</creatorcontrib><creatorcontrib>Cruz, Dinna N</creatorcontrib><creatorcontrib>Fumagalli, Roberto</creatorcontrib><creatorcontrib>Kindgen-Milles, Detlef</creatorcontrib><creatorcontrib>Monti, Gianpaola</creatorcontrib><creatorcontrib>Marinho, Anibal</creatorcontrib><creatorcontrib>Mariano, Filippo</creatorcontrib><creatorcontrib>Formica, Marco</creatorcontrib><creatorcontrib>Marchesi, Mariano</creatorcontrib><creatorcontrib>René, Robert</creatorcontrib><creatorcontrib>Livigni, Sergio</creatorcontrib><creatorcontrib>Ronco, Claudio</creatorcontrib><creatorcontrib>DOse REsponse Multicentre International collaborative Initiative (DO-RE-MI Study Group)</creatorcontrib><creatorcontrib>the DOse REsponse Multicentre International collaborative Initiative (DO-RE-MI Study Group)</creatorcontrib><title>Delivered dose of renal replacement therapy and mortality in critically ill patients with acute kidney injury</title><title>Critical care (London, England)</title><addtitle>Crit Care</addtitle><description>The optimal dialysis dose for the treatment of acute kidney injury (AKI) is controversial. We sought to evaluate the relationship between renal replacement therapy (RRT) dose and outcome.
We performed a prospective multicentre observational study in 30 intensive care units (ICUs) in eight countries from June 2005 to December 2007. Delivered RRT dose was calculated in patients treated exclusively with either continuous RRT (CRRT) or intermittent RRT (IRRT) during their ICU stay. Dose was categorised into more-intensive (CRRT >or= 35 ml/kg/hour, IRRT >or= 6 sessions/week) or less-intensive (CRRT < 35 ml/kg/hour, IRRT < 6 sessions/week). The main outcome measures were ICU mortality, ICU length of stay and duration of mechanical ventilation.
Of 15,200 critically ill patients admitted during the study period, 553 AKI patients were treated with RRT, including 338 who received CRRT only and 87 who received IRRT only. For CRRT, the median delivered dose was 27.1 ml/kg/hour (interquartile range (IQR) = 22.1 to 33.9). For IRRT, the median dose was 7 sessions/week (IQR = 5 to 7). Only 22% of CRRT patients and 64% of IRRT patients received a more-intensive dose. Crude ICU mortality among CRRT patients were 60.8% vs. 52.5% (more-intensive vs. less-intensive groups, respectively). In IRRT, this was 23.6 vs. 19.4%, respectively. On multivariable analysis, there was no significant association between RRT dose and ICU mortality (Odds ratio (OR) more-intensive vs. less-intensive: CRRT OR = 1.21, 95% confidence interval (CI) = 0.66 to 2.21; IRRT OR = 1.50, 95% CI = 0.48 to 4.67). Among survivors, shorter ICU stay and duration of mechanical ventilation were observed in the more-intensive RRT groups (more-intensive vs. less-intensive for all: CRRT (median): 15 (IQR = 8 to 26) vs. 19.5 (IQR = 12 to 33.5) ICU days, P = 0.063; 7 (IQR = 4 to 17) vs. 14 (IQR = 5 to 24) ventilation days, P = 0.031; IRRT: 8 (IQR = 5.5 to 14) vs. 18 (IQR = 13 to 35) ICU days, P = 0.008; 2.5 (IQR = 0 to 10) vs. 12 (IQR = 3 to 24) ventilation days, P = 0.026).
After adjustment for multiple variables, these data provide no evidence for a survival benefit afforded by higher dose RRT. However, more-intensive RRT was associated with a favourable effect on ICU stay and duration of mechanical ventilation among survivors. This result warrants further exploration.
Cochrane Renal Group (CRG110600093).</description><subject>Acute Kidney Injury - mortality</subject><subject>Acute Kidney Injury - therapy</subject><subject>Acute renal failure</subject><subject>Adult</subject><subject>Aged</subject><subject>Care and treatment</subject><subject>Critical Illness</subject><subject>Critically ill</subject><subject>Demographic aspects</subject><subject>Dialysis Solutions - administration & dosage</subject><subject>Dose-Response Relationship, Drug</subject><subject>Endpoint Determination</subject><subject>Female</subject><subject>Humans</subject><subject>Intensive Care Units</subject><subject>Male</subject><subject>Methods</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Outcome Assessment, Health Care</subject><subject>Patient outcomes</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Renal Replacement Therapy - methods</subject><issn>1364-8535</issn><issn>1466-609X</issn><issn>1364-8535</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kk1v1DAQhi0Eou0CPwFZHLil2HHs2BekqrQFqVIvReJm2c6k68WJg-MU7b_Hq6woPSBL_pp3npnxGKF3lJxTKsUn59pWNi_QKW2EqARRP16WPRNNJTnjJ-hsnneE0FYK9hqdUMWEbOvmFA1fIPhHSNDhLs6AY48TjCaUeQrGwQBjxnkLyUx7bMYODzFlE3zeYz9il3z2zoRQTiHgyWRf9DP-7fMWG7dkwD99N8JBvFvS_g161Zsww9vjukHfr6_uL79Wt3c33y4vbivbSJIrziwnhLeWKSUaJaAWtKsdNcRZQcC1FkhXS8ZNzaxTFBQYYS1pLVGcND3boM8rd1rsAJ0rSSUT9JT8YNJeR-P1c8vot_ohPupayAOhANQKsD7-B_Dc4uKg1x4U3w_H4Cn-WmDOeheXVN501lTxRhDZ8CI6X0UPJoD2Yx8LxpXRweBdHKH35f6CKsU5kaXWDfq4OrgU5zlB_zcZSvThCzyFf_9v7U-yY8_ZH6FMr7k</recordid><startdate>20090101</startdate><enddate>20090101</enddate><creator>Vesconi, Sergio</creator><creator>Cruz, Dinna N</creator><creator>Fumagalli, Roberto</creator><creator>Kindgen-Milles, Detlef</creator><creator>Monti, Gianpaola</creator><creator>Marinho, Anibal</creator><creator>Mariano, Filippo</creator><creator>Formica, Marco</creator><creator>Marchesi, Mariano</creator><creator>René, Robert</creator><creator>Livigni, Sergio</creator><creator>Ronco, Claudio</creator><general>BioMed Central Ltd</general><general>National Library of Medicine - MEDLINE Abstracts</general><general>BioMed Central</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>5PM</scope></search><sort><creationdate>20090101</creationdate><title>Delivered dose of renal replacement therapy and mortality in critically ill patients with acute kidney injury</title><author>Vesconi, Sergio ; Cruz, Dinna N ; Fumagalli, Roberto ; Kindgen-Milles, Detlef ; Monti, Gianpaola ; Marinho, Anibal ; Mariano, Filippo ; Formica, Marco ; Marchesi, Mariano ; René, Robert ; Livigni, Sergio ; Ronco, Claudio</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b480t-53b50057b3996496e261d2c1a0cb60ec7be0d2835a23bc91e9ea6bb07b09504f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Acute Kidney Injury - mortality</topic><topic>Acute Kidney Injury - therapy</topic><topic>Acute renal failure</topic><topic>Adult</topic><topic>Aged</topic><topic>Care and treatment</topic><topic>Critical Illness</topic><topic>Critically ill</topic><topic>Demographic aspects</topic><topic>Dialysis Solutions - administration & dosage</topic><topic>Dose-Response Relationship, Drug</topic><topic>Endpoint Determination</topic><topic>Female</topic><topic>Humans</topic><topic>Intensive Care Units</topic><topic>Male</topic><topic>Methods</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Outcome Assessment, Health Care</topic><topic>Patient outcomes</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Renal Replacement Therapy - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Vesconi, Sergio</creatorcontrib><creatorcontrib>Cruz, Dinna N</creatorcontrib><creatorcontrib>Fumagalli, Roberto</creatorcontrib><creatorcontrib>Kindgen-Milles, Detlef</creatorcontrib><creatorcontrib>Monti, Gianpaola</creatorcontrib><creatorcontrib>Marinho, Anibal</creatorcontrib><creatorcontrib>Mariano, Filippo</creatorcontrib><creatorcontrib>Formica, Marco</creatorcontrib><creatorcontrib>Marchesi, Mariano</creatorcontrib><creatorcontrib>René, Robert</creatorcontrib><creatorcontrib>Livigni, Sergio</creatorcontrib><creatorcontrib>Ronco, Claudio</creatorcontrib><creatorcontrib>DOse REsponse Multicentre International collaborative Initiative (DO-RE-MI Study Group)</creatorcontrib><creatorcontrib>the DOse REsponse Multicentre International collaborative Initiative (DO-RE-MI Study Group)</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Critical care (London, England)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Vesconi, Sergio</au><au>Cruz, Dinna N</au><au>Fumagalli, Roberto</au><au>Kindgen-Milles, Detlef</au><au>Monti, Gianpaola</au><au>Marinho, Anibal</au><au>Mariano, Filippo</au><au>Formica, Marco</au><au>Marchesi, Mariano</au><au>René, Robert</au><au>Livigni, Sergio</au><au>Ronco, Claudio</au><aucorp>DOse REsponse Multicentre International collaborative Initiative (DO-RE-MI Study Group)</aucorp><aucorp>the DOse REsponse Multicentre International collaborative Initiative (DO-RE-MI Study Group)</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Delivered dose of renal replacement therapy and mortality in critically ill patients with acute kidney injury</atitle><jtitle>Critical care (London, England)</jtitle><addtitle>Crit Care</addtitle><date>2009-01-01</date><risdate>2009</risdate><volume>13</volume><issue>2</issue><spage>R57</spage><epage>R57</epage><pages>R57-R57</pages><artnum>R57</artnum><issn>1364-8535</issn><eissn>1466-609X</eissn><eissn>1364-8535</eissn><abstract>The optimal dialysis dose for the treatment of acute kidney injury (AKI) is controversial. We sought to evaluate the relationship between renal replacement therapy (RRT) dose and outcome.
We performed a prospective multicentre observational study in 30 intensive care units (ICUs) in eight countries from June 2005 to December 2007. Delivered RRT dose was calculated in patients treated exclusively with either continuous RRT (CRRT) or intermittent RRT (IRRT) during their ICU stay. Dose was categorised into more-intensive (CRRT >or= 35 ml/kg/hour, IRRT >or= 6 sessions/week) or less-intensive (CRRT < 35 ml/kg/hour, IRRT < 6 sessions/week). The main outcome measures were ICU mortality, ICU length of stay and duration of mechanical ventilation.
Of 15,200 critically ill patients admitted during the study period, 553 AKI patients were treated with RRT, including 338 who received CRRT only and 87 who received IRRT only. For CRRT, the median delivered dose was 27.1 ml/kg/hour (interquartile range (IQR) = 22.1 to 33.9). For IRRT, the median dose was 7 sessions/week (IQR = 5 to 7). Only 22% of CRRT patients and 64% of IRRT patients received a more-intensive dose. Crude ICU mortality among CRRT patients were 60.8% vs. 52.5% (more-intensive vs. less-intensive groups, respectively). In IRRT, this was 23.6 vs. 19.4%, respectively. On multivariable analysis, there was no significant association between RRT dose and ICU mortality (Odds ratio (OR) more-intensive vs. less-intensive: CRRT OR = 1.21, 95% confidence interval (CI) = 0.66 to 2.21; IRRT OR = 1.50, 95% CI = 0.48 to 4.67). Among survivors, shorter ICU stay and duration of mechanical ventilation were observed in the more-intensive RRT groups (more-intensive vs. less-intensive for all: CRRT (median): 15 (IQR = 8 to 26) vs. 19.5 (IQR = 12 to 33.5) ICU days, P = 0.063; 7 (IQR = 4 to 17) vs. 14 (IQR = 5 to 24) ventilation days, P = 0.031; IRRT: 8 (IQR = 5.5 to 14) vs. 18 (IQR = 13 to 35) ICU days, P = 0.008; 2.5 (IQR = 0 to 10) vs. 12 (IQR = 3 to 24) ventilation days, P = 0.026).
After adjustment for multiple variables, these data provide no evidence for a survival benefit afforded by higher dose RRT. However, more-intensive RRT was associated with a favourable effect on ICU stay and duration of mechanical ventilation among survivors. This result warrants further exploration.
Cochrane Renal Group (CRG110600093).</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>19368724</pmid><doi>10.1186/cc7784</doi><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Springer Nature - Complete Springer Journals; DOAJ Directory of Open Access Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central; Alma/SFX Local Collection; Springer Nature OA Free Journals |
| subjects | Acute Kidney Injury - mortality Acute Kidney Injury - therapy Acute renal failure Adult Aged Care and treatment Critical Illness Critically ill Demographic aspects Dialysis Solutions - administration & dosage Dose-Response Relationship, Drug Endpoint Determination Female Humans Intensive Care Units Male Methods Middle Aged Mortality Outcome Assessment, Health Care Patient outcomes Prognosis Prospective Studies Renal Replacement Therapy - methods |
| title | Delivered dose of renal replacement therapy and mortality in critically ill patients with acute kidney injury |
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