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Predicting restoration of kidney function during CRRT-free intervals
BACKGROUND: Renal failure is common in critically ill patients and frequently requires continuous renal replacement therapy (CRRT). CRRT is discontinued at regular intervals for routine changes of the disposable equipment or for replacing clogged filter membrane assemblies. The present study was con...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2012
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3275482/ https://www.ncbi.nlm.nih.gov/pubmed/22257468 http://dx.doi.org/10.1186/1749-8090-7-6 |
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author | Heise, Daniel Gries, Daniel Moerer, Onnen Bleckmann, Annalen Quintel, Michael |
author_facet | Heise, Daniel Gries, Daniel Moerer, Onnen Bleckmann, Annalen Quintel, Michael |
author_sort | Heise, Daniel |
collection | PubMed |
description | BACKGROUND: Renal failure is common in critically ill patients and frequently requires continuous renal replacement therapy (CRRT). CRRT is discontinued at regular intervals for routine changes of the disposable equipment or for replacing clogged filter membrane assemblies. The present study was conducted to determine if the necessity to continue CRRT could be predicted during the CRRT-free period. MATERIALS AND METHODS: In the period from 2003 to 2006, 605 patients were treated with CRRT in our ICU. A total of 222 patients with 448 CRRT-free intervals had complete data sets and were used for analysis. Of the total CRRT-free periods, 225 served as an evaluation group. Twenty-nine parameters with an assumed influence on kidney function were analyzed with regard to their potential to predict the restoration of kidney function during the CRRT-free interval. Using univariate analysis and logistic regression, a prospective index was developed and validated in the remaining 223 CRRT-free periods to establish its prognostic strength. RESULTS: Only three parameters showed an independent influence on the restoration of kidney function during CRRT-free intervals: the number of previous CRRT cycles (medians in the two outcome groups: 1 vs. 2), the "Sequential Organ Failure Assessment"-score (means in the two outcome groups: 8.3 vs. 9.2) and urinary output after the cessation of CRRT (medians in two outcome groups: 66 ml/h vs. 10 ml/h). The prognostic index, which was calculated from these three variables, showed a satisfactory potential to predict the kidney function during the CRRT-free intervals; Receiver operating characteristic (ROC) analysis revealed an area under the curve of 0.798. CONCLUSION: Restoration of kidney function during CRRT-free periods can be predicted with an index calculated from three variables. Prospective trials in other hospitals must clarify whether our results are generally transferable to other patient populations. |
format | Online Article Text |
id | pubmed-3275482 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2012 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-32754822012-02-13 Predicting restoration of kidney function during CRRT-free intervals Heise, Daniel Gries, Daniel Moerer, Onnen Bleckmann, Annalen Quintel, Michael J Cardiothorac Surg Research Article BACKGROUND: Renal failure is common in critically ill patients and frequently requires continuous renal replacement therapy (CRRT). CRRT is discontinued at regular intervals for routine changes of the disposable equipment or for replacing clogged filter membrane assemblies. The present study was conducted to determine if the necessity to continue CRRT could be predicted during the CRRT-free period. MATERIALS AND METHODS: In the period from 2003 to 2006, 605 patients were treated with CRRT in our ICU. A total of 222 patients with 448 CRRT-free intervals had complete data sets and were used for analysis. Of the total CRRT-free periods, 225 served as an evaluation group. Twenty-nine parameters with an assumed influence on kidney function were analyzed with regard to their potential to predict the restoration of kidney function during the CRRT-free interval. Using univariate analysis and logistic regression, a prospective index was developed and validated in the remaining 223 CRRT-free periods to establish its prognostic strength. RESULTS: Only three parameters showed an independent influence on the restoration of kidney function during CRRT-free intervals: the number of previous CRRT cycles (medians in the two outcome groups: 1 vs. 2), the "Sequential Organ Failure Assessment"-score (means in the two outcome groups: 8.3 vs. 9.2) and urinary output after the cessation of CRRT (medians in two outcome groups: 66 ml/h vs. 10 ml/h). The prognostic index, which was calculated from these three variables, showed a satisfactory potential to predict the kidney function during the CRRT-free intervals; Receiver operating characteristic (ROC) analysis revealed an area under the curve of 0.798. CONCLUSION: Restoration of kidney function during CRRT-free periods can be predicted with an index calculated from three variables. Prospective trials in other hospitals must clarify whether our results are generally transferable to other patient populations. BioMed Central 2012-01-18 /pmc/articles/PMC3275482/ /pubmed/22257468 http://dx.doi.org/10.1186/1749-8090-7-6 Text en Copyright ©2012 Heise 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 Article Heise, Daniel Gries, Daniel Moerer, Onnen Bleckmann, Annalen Quintel, Michael Predicting restoration of kidney function during CRRT-free intervals |
title | Predicting restoration of kidney function during CRRT-free intervals |
title_full | Predicting restoration of kidney function during CRRT-free intervals |
title_fullStr | Predicting restoration of kidney function during CRRT-free intervals |
title_full_unstemmed | Predicting restoration of kidney function during CRRT-free intervals |
title_short | Predicting restoration of kidney function during CRRT-free intervals |
title_sort | predicting restoration of kidney function during crrt-free intervals |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3275482/ https://www.ncbi.nlm.nih.gov/pubmed/22257468 http://dx.doi.org/10.1186/1749-8090-7-6 |
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