Management of renal replacement therapy in acute kidney injury: A survey of practitioner prescribing practices

Pamela Overberger, Matthew Pesacreta, Paul M. Palevsky, Theresa Z. O'Connor, Jane H. Zhang, Glenn M. Chertow, Susan Crowley, Devasmita Dev, John Kellum, Emil Paganini, Roland M.H. Schein, B. Taylor Thompson, Mark W. Smith, Kathy Swanson, Peter Peduzzi, Robert Star, Eric Young, James Lohr, George Dolson, Robert BacallaoMay Jo Shaver, Jeffrey Kraut, T. Alp Ikizler, Vecihi Batuman, Mohan Ramkumar, Suzanne Watnick, George Feldman, Francis Gabbai, Kirsten Johansen, Carlos Rosado-Rodriguez, Dennis Andress, Hamid Rabb, John Niles, Gabriel Contreras, Nabeel Aslam, Kevin Finkel, Andrew Shaw, Michael Rocco, Anitha Vijayan

Research output: Contribution to journalArticle

79 Scopus citations

Abstract

Background: Data on current practices for management of renal replacement therapy (RRT) in acute kidney injury (AKI) are limited, particularly with regard to the dosing of therapy. Design, setting, par ticipants, and measurements: A survey was conducted of practitioners at the 27 study sites that participate in the Veterans Affairs/National Institutes of Health Acute Renal Trial Network (ATN) Study before initiation of patient enrollment for ascertainment of the local prevailing practices for management of RRT in critically ill patients with AKI. Surveys were returned from 130 practitioners at 26 of 27 study sites; the remaining study site provided aggregate data. Resul ts: Intermittent hemodialysis and continuous RRT were the most commonly used modalities of RRT, with sustained low-efficiency dialysis and other "hybrid" treatments used in fewer than 10% of patients. Intermittent hemodialysis was most commonly provided on a thrice-weekly or every-other-day schedule, with only infrequent assessment of the delivered dosage of therapy. Most practitioners reported that they did not dose continuous RRT on the basis of patient weight. The average prescribed dosage of therapy corresponded to a weight-based dosage of no more than 20 to 25 ml/kg per h. Conclusions: These results provide insi ght into clinical management of RRT and provide normative data for evaluation of the design of ongoing clinical trials.

Original languageEnglish (US)
Pages (from-to)623-630
Number of pages8
JournalClinical Journal of the American Society of Nephrology
Volume2
Issue number4
DOIs
StatePublished - Jul 1 2007
Externally publishedYes

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ASJC Scopus subject areas

  • Epidemiology
  • Critical Care and Intensive Care Medicine
  • Nephrology
  • Transplantation

Cite this

Overberger, P., Pesacreta, M., Palevsky, P. M., O'Connor, T. Z., Zhang, J. H., Chertow, G. M., Crowley, S., Dev, D., Kellum, J., Paganini, E., Schein, R. M. H., Thompson, B. T., Smith, M. W., Swanson, K., Peduzzi, P., Star, R., Young, E., Lohr, J., Dolson, G., ... Vijayan, A. (2007). Management of renal replacement therapy in acute kidney injury: A survey of practitioner prescribing practices. Clinical Journal of the American Society of Nephrology, 2(4), 623-630. https://doi.org/10.2215/CJN.00780207