Cargando…

Cost of acute renal replacement therapy in the intensive care unit: results from The Beginning and Ending Supportive Therapy for the Kidney (BEST Kidney) Study

INTRODUCTION: Severe acute kidney injury (AKI) can be treated with either continuous renal replacement therapy (CRRT) or intermittent renal replacement therapy (IRRT). Limited evidence from existing studies does not support an outcome advantage of one modality versus the other, and most centers arou...

Descripción completa

Detalles Bibliográficos
Autores principales: Srisawat, Nattachai, Lawsin, Loredo, Uchino, Shigehiko, Bellomo, Rinaldo, Kellum, John A
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2887158/
https://www.ncbi.nlm.nih.gov/pubmed/20346163
http://dx.doi.org/10.1186/cc8933
_version_ 1782182516972584960
author Srisawat, Nattachai
Lawsin, Loredo
Uchino, Shigehiko
Bellomo, Rinaldo
Kellum, John A
author_facet Srisawat, Nattachai
Lawsin, Loredo
Uchino, Shigehiko
Bellomo, Rinaldo
Kellum, John A
author_sort Srisawat, Nattachai
collection PubMed
description INTRODUCTION: Severe acute kidney injury (AKI) can be treated with either continuous renal replacement therapy (CRRT) or intermittent renal replacement therapy (IRRT). Limited evidence from existing studies does not support an outcome advantage of one modality versus the other, and most centers around the word use both modalities according to patient needs. However, cost estimates involve multiple factors that may not be generalizable to other sites, and, to date, only single-center cost studies have been performed. The aim of this study was to estimate the cost difference between CRRT and IRRT in the intensive care unit (ICU). METHODS: We performed a post hoc analysis of a prospective observational study among 53 centers from 23 countries, from September 2000 to December 2001. We estimated costs based on staffing, as well as dialysate and replacement fluid, anticoagulation and extracorporeal circuit. RESULTS: We found that the theoretic range of costs were from $3,629.80/day more with CRRT to $378.60/day more with IRRT. The median difference in cost between CRRT and IRRT was $289.60 (IQR 830.8-116.8) per day (greater with CRRT). Costs also varied greatly by region. Reducing replacement fluid volumes in CRRT to ≤ 25 ml/min (approximately 25 ml/kg/hr) would result in $67.20/day (23.2%) mean savings. CONCLUSIONS: Cost considerations with RRT are important and vary substantially among centers. We identified the relative impact of four cost domains (nurse staffing, fluid, anticoagulation, and extracorporeal circuit) on overall cost differences, and hospitals can look to these areas to reduce costs associated with RRT.
format Text
id pubmed-2887158
institution National Center for Biotechnology Information
language English
publishDate 2010
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-28871582010-06-18 Cost of acute renal replacement therapy in the intensive care unit: results from The Beginning and Ending Supportive Therapy for the Kidney (BEST Kidney) Study Srisawat, Nattachai Lawsin, Loredo Uchino, Shigehiko Bellomo, Rinaldo Kellum, John A Crit Care Research INTRODUCTION: Severe acute kidney injury (AKI) can be treated with either continuous renal replacement therapy (CRRT) or intermittent renal replacement therapy (IRRT). Limited evidence from existing studies does not support an outcome advantage of one modality versus the other, and most centers around the word use both modalities according to patient needs. However, cost estimates involve multiple factors that may not be generalizable to other sites, and, to date, only single-center cost studies have been performed. The aim of this study was to estimate the cost difference between CRRT and IRRT in the intensive care unit (ICU). METHODS: We performed a post hoc analysis of a prospective observational study among 53 centers from 23 countries, from September 2000 to December 2001. We estimated costs based on staffing, as well as dialysate and replacement fluid, anticoagulation and extracorporeal circuit. RESULTS: We found that the theoretic range of costs were from $3,629.80/day more with CRRT to $378.60/day more with IRRT. The median difference in cost between CRRT and IRRT was $289.60 (IQR 830.8-116.8) per day (greater with CRRT). Costs also varied greatly by region. Reducing replacement fluid volumes in CRRT to ≤ 25 ml/min (approximately 25 ml/kg/hr) would result in $67.20/day (23.2%) mean savings. CONCLUSIONS: Cost considerations with RRT are important and vary substantially among centers. We identified the relative impact of four cost domains (nurse staffing, fluid, anticoagulation, and extracorporeal circuit) on overall cost differences, and hospitals can look to these areas to reduce costs associated with RRT. BioMed Central 2010 2010-03-26 /pmc/articles/PMC2887158/ /pubmed/20346163 http://dx.doi.org/10.1186/cc8933 Text en Copyright ©2010 Nattachai Srisawat et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research
Srisawat, Nattachai
Lawsin, Loredo
Uchino, Shigehiko
Bellomo, Rinaldo
Kellum, John A
Cost of acute renal replacement therapy in the intensive care unit: results from The Beginning and Ending Supportive Therapy for the Kidney (BEST Kidney) Study
title Cost of acute renal replacement therapy in the intensive care unit: results from The Beginning and Ending Supportive Therapy for the Kidney (BEST Kidney) Study
title_full Cost of acute renal replacement therapy in the intensive care unit: results from The Beginning and Ending Supportive Therapy for the Kidney (BEST Kidney) Study
title_fullStr Cost of acute renal replacement therapy in the intensive care unit: results from The Beginning and Ending Supportive Therapy for the Kidney (BEST Kidney) Study
title_full_unstemmed Cost of acute renal replacement therapy in the intensive care unit: results from The Beginning and Ending Supportive Therapy for the Kidney (BEST Kidney) Study
title_short Cost of acute renal replacement therapy in the intensive care unit: results from The Beginning and Ending Supportive Therapy for the Kidney (BEST Kidney) Study
title_sort cost of acute renal replacement therapy in the intensive care unit: results from the beginning and ending supportive therapy for the kidney (best kidney) study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2887158/
https://www.ncbi.nlm.nih.gov/pubmed/20346163
http://dx.doi.org/10.1186/cc8933
work_keys_str_mv AT srisawatnattachai costofacuterenalreplacementtherapyintheintensivecareunitresultsfromthebeginningandendingsupportivetherapyforthekidneybestkidneystudy
AT lawsinloredo costofacuterenalreplacementtherapyintheintensivecareunitresultsfromthebeginningandendingsupportivetherapyforthekidneybestkidneystudy
AT uchinoshigehiko costofacuterenalreplacementtherapyintheintensivecareunitresultsfromthebeginningandendingsupportivetherapyforthekidneybestkidneystudy
AT bellomorinaldo costofacuterenalreplacementtherapyintheintensivecareunitresultsfromthebeginningandendingsupportivetherapyforthekidneybestkidneystudy
AT kellumjohna costofacuterenalreplacementtherapyintheintensivecareunitresultsfromthebeginningandendingsupportivetherapyforthekidneybestkidneystudy