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01-05-2018 | What's New in Intensive Care

Can this patient be safely weaned from RRT?

Authors: Kada Klouche, R. T. Noel Gibney, Lui G. Forni

Published in: Intensive Care Medicine | Issue 5/2018

Excerpt

The timing of initiation of renal replacement therapy (RRT) in the critically ill with acute kidney injury (AKI) has been widely studied and discussed in detail recently [1‐3]. However, there is limited information and few recommendations for when to discontinue RRT in patients who appear to be improving. …

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Mendu ML, Ciociolo GR Jr, McLaughlin SR, Graham DA, Ghazinouri R, Parmar S, Grossier A, Rosen R, Laskowski KR, Riella LV, Robinson ES, Charytan DM, Bonventre JV, Greenberg JO, Waikar SS (2017) A decision-making algorithm for initiation and discontinuation of RRT in severe AKI. Clin J Am Soc Nephrol 12:228–236CrossRefPubMedPubMedCentral

Zarbock A, Kellum JA, Schmidt C, Van Aken H, Wempe C, Pavenstadt H et al (2016) Effect of early vs delayed initiation of renal replacement therapy on mortality in critically ill patients with acute kidney injury: the ELAIN randomized clinical trial. JAMA 315(20):2190–2199CrossRefPubMed

Gaudry S, Hajage D, Schortgen F, Martin-Lefevre L, Pons B, Boulet E et al (2016) Initiation strategies for renal-replacement therapy in the intensive care unit. N Engl J Med 375:122–133CrossRefPubMed

Elseviers MM, Lins RL, Van der Niepen P, Hoste E, Malbrain ML, Damas P, Devriendt J (2010) Renal replacement therapy is an independent risk factor for mortality in critically ill patients with acute kidney injury. Crit Care 14:R221CrossRefPubMedPubMedCentral

Bagshaw SM, Uchino S, Kellum JA, Morimatsu H, Morgera S, Schetz M, Tan I, Bouman C, Macedo E, Gibney N, Tolwani A, Oudemans-van Straaten HM, Ronco C, Bellomo R (2013) Association between renal replacement therapy in critically ill patients with severe acute kidney injury and mortality. J Crit Care 28:1011–1018CrossRefPubMed

Schiffl H (2008) Renal recovery after severe acute renal injury. Eur J Med Res 13:552–556PubMed

Uchino S, Bellomo R, Morimatsu H, Morgera S, Schetz M, Tan I et al (2009) Discontinuation of continuous renal replacement therapy: a post hoc analysis of a prospective multicenter observational study. Crit Care Med 37:2576–2582CrossRefPubMed

Wu VC, Ko WJ, Chang HW, Chen YW, Lin YF, Shiao CC et al (2008) Risk factors of early redialysis after weaning from postoperative acute renal replacement therapy. Intensive Care Med 34:101–108CrossRefPubMed

Fröhlich S, Donnelly A, Solymos O, Conlon N (2012) Use of 2-hour creatinine clearance to guide cessation of continuous renal replacement therapy. J Crit Care 27(744):e1–e5

10.

Viallet N, Brunot V, Kuster N, Daubin D, Besnard N, Platon L et al (2016) Daily urinary creatinine predicts the weaning of renal replacement therapy in ICU acute kidney injury patients. Ann Intensive Care 6:71CrossRefPubMedPubMedCentral

11.

Aniort J, Ait Hssain A, Pereira B, Coupez E, Pioche PA, Leroy C et al (2016) Daily urinary urea excretion to guide intermittent hemodialysis weaning in critically ill patients. Crit Care 20:43CrossRefPubMedPubMedCentral

12.

Yang T, Sun S1, Zhao Y, Liu Q, Han M, Lin L, Su B, Huang S, Yang L (2017) Biomarkers upon discontinuation of renal replacement therapy predict 60-day survival and renal recovery in critically ill patients with acute kidney injury. Hemodial Int. doi:10.1111/hdi.12532

13.

Srisawat N, Wen X, Lee M, Kong L, Elder M, Carter M, Unruh M, Finkel K, Vijayan A, Ramkumar M, Paganini E, Singbartl K, Palevsky PM, Kellum JA (2011) Urinary biomarkers and renal recovery in critically ill patients with renal support. Clin J Am Soc Nephrol 6:1815–1823CrossRefPubMedPubMedCentral

14.

Forni LG, Darmon M, Ostermann M, Oudemans-van Straaten HM, Pettilä V, Prowle JR, Schetz M, Joannidis M (2017) Renal recovery after acute kidney injury. Intensive Care Med 43:855–866

15.

Han SS, Bae E, Song SH, Kim DK, Kim YS, Han JS, Joo KW (2016) NT-proBNP is predictive of the weaning from continuous renal replacement therapy. Tohoku J Exp Med 239:1–8CrossRefPubMed

Title: Can this patient be safely weaned from RRT?
Authors: Kada Klouche
R. T. Noel Gibney
Lui G. Forni
Publication date: 01-05-2018
Publisher: Springer Berlin Heidelberg
Published in: Intensive Care Medicine / Issue 5/2018
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-017-4948-0

At a glance: The STEP trials

Springer Medicine

Can this patient be safely weaned from RRT?

Excerpt

At a glance: The STEP trials

Springer Medicine

Excerpt

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