The Effect of Specialized Continuous Renal Replacement Therapy Team in Acute Kidney Injury Patients Treatment.
10.3349/ymj.2015.56.3.658
- Author:
Youn Kyung KEE
1
;
Eun Jin KIM
;
Kyoung Sook PARK
;
Seung Gyu HAN
;
In Mee HAN
;
Chang Yun YOON
;
Eunyoung LEE
;
Young Su JOO
;
Dae Young KIM
;
Mi Jung LEE
;
Jung Tak PARK
;
Seung Hyeok HAN
;
Tae Hyun YOO
;
Beom Seok KIM
;
Shin Wook KANG
;
Kyu Hun CHOI
;
Hyung Jung OH
Author Information
1. Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. ohjmd@yuhs.ac
- Publication Type:Original Article ; Comparative Study ; Research Support, Non-U.S. Gov't
- Keywords:
SCT management;
acute kidney injury;
continuous renal replacement therapy;
28-day mortality
- MeSH:
Acute Kidney Injury/mortality/*therapy;
Adult;
Aged;
Aged, 80 and over;
Biological Markers;
Critical Illness/*mortality/therapy;
Female;
Humans;
Intensive Care Units;
Kaplan-Meier Estimate;
Kidney Failure, Chronic/*therapy;
Male;
Middle Aged;
Patient Care Team;
Proportional Hazards Models;
Renal Replacement Therapy/*methods;
Retrospective Studies;
Time Factors;
Treatment Outcome
- From:Yonsei Medical Journal
2015;56(3):658-665
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Continuous renal replacement therapy (CRRT) has been established for critically ill acute kidney injury (AKI) patients. In addition, some centers consist of a specialized CRRT team (SCT) with physicians and nurses. To our best knowledge, however, ona a few studies have yet been carried out on the superiority of SCT management. MATERIALS AND METHODS: A total of 551 patients, who received CRRT between January 2008 and March 2009, were divided into two groups based on the controller of CRRT. The impact of the CRRT management on 28-day mortality was compared between two groups by Kaplan-Meier curve and Cox analysis. RESULTS: During the study period, the number of filters used, down-time per day, and intensive care unit length of day were significantly higher in non-SCT group than in SCT group (6.2 hrs vs. 5.0 hrs, p=0.042; 5.0 hrs vs. 3.8 hrs, p<0.001; 27.5 days vs. 21.1 days, p=0.027, respectively), while net ultrafiltration rate was significantly lower in non-SCT group than SCT group (28.0 mL/kg/hr vs. 29.5 mL/kg/hr, p=0.043, respectively). In addition, 28-day mortality rate was significantly lower in SCT group than with non-SCT group (p=0.031). Moreover, Cox regression analysis showed that 28-day mortality rate was significantly lower in SCT control group, even after adjusting for age, gender, severity scores, biomarkers, risk, injury, failure, loss, and end-stage renal disease, and contributing factors (hazard ratio 0.91, p=0.046). CONCLUSION: A well-trained CRRT team could be beneficial for mortality improvement of AKI patients requiring CRRT.
