{"title":"Current status of continuous renal replacement therapy in Japanese intensive care units: a multicenter retrospective observational study.","authors":"Hidehiko Nakano, Ryota Inokuchi, Yutaro Inoue, Motohiro Sekino, Yasuyuki Kakihana, Noriyuki Hattori, Mariko Miyazaki, Natsuko Tokuhira, Shigeki Fujitani, Yuichiro Toda, Yoshifumi Ohchi, Hiroshi Morimatsu, Shingo Ichiba, Yoshiki Masuda, Osamu Nishida, Takaya Abe, Takeshi Moriguchi, Kasumi Satoh, Masafumi Idei, Hiromasa Nagata, Kent Doi","doi":"10.1159/000548371","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Continuous renal replacement therapy (CRRT) is often performed for critically ill patients in intensive care units (ICUs), but its optimal indication and settings have yet to be determined. Thus, we aimed to describe the current status of CRRT in Japan through a multicenter retrospective observational study.</p><p><strong>Methods: </strong>Adult ICU patients receiving CRRT at 18 tertiary hospitals in Japan (up to 100 patients from each hospital over the past year) were retrospectively enrolled. Patients receiving CRRT for <24 hours or intermittent renal replacement therapy together with CRRT were excluded. The primary outcomes were the temporal changes in the electrolyte levels, acid-base balance, and uremia-related small solute concentrations. The secondary outcomes included potassium (K) and phosphate (P) supplementations during CRRT.</p><p><strong>Results: </strong>Altogether, 1045 patients were enrolled. The median CRRT duration and dose were 4.4 days and 17.3 mL/kg/hr, respectively. The electrolyte levels, acid-base balance, and uremia-related small solute concentrations returned to normal by day 4 of treatment. A total of 732 (70.0 %) patients received K supplementation, and only a few patients had hypokalemia until day 5. Moreover, 414 (39.6%) patients received P supplementation, and approximately 30%-50% of the patients had hypophosphatemia until day 5.</p><p><strong>Conclusion: </strong>The electrolyte level abnormalities and acid-base imbalances of the studied patients were improved within 72-96 hours of CRRT. Contrarily, K and P supplementations were common, indicating that the current CRRT solutions need to be modified.</p>","PeriodicalId":8953,"journal":{"name":"Blood Purification","volume":" ","pages":"1-19"},"PeriodicalIF":1.8000,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Blood Purification","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1159/000548371","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"HEMATOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction: Continuous renal replacement therapy (CRRT) is often performed for critically ill patients in intensive care units (ICUs), but its optimal indication and settings have yet to be determined. Thus, we aimed to describe the current status of CRRT in Japan through a multicenter retrospective observational study.
Methods: Adult ICU patients receiving CRRT at 18 tertiary hospitals in Japan (up to 100 patients from each hospital over the past year) were retrospectively enrolled. Patients receiving CRRT for <24 hours or intermittent renal replacement therapy together with CRRT were excluded. The primary outcomes were the temporal changes in the electrolyte levels, acid-base balance, and uremia-related small solute concentrations. The secondary outcomes included potassium (K) and phosphate (P) supplementations during CRRT.
Results: Altogether, 1045 patients were enrolled. The median CRRT duration and dose were 4.4 days and 17.3 mL/kg/hr, respectively. The electrolyte levels, acid-base balance, and uremia-related small solute concentrations returned to normal by day 4 of treatment. A total of 732 (70.0 %) patients received K supplementation, and only a few patients had hypokalemia until day 5. Moreover, 414 (39.6%) patients received P supplementation, and approximately 30%-50% of the patients had hypophosphatemia until day 5.
Conclusion: The electrolyte level abnormalities and acid-base imbalances of the studied patients were improved within 72-96 hours of CRRT. Contrarily, K and P supplementations were common, indicating that the current CRRT solutions need to be modified.
期刊介绍：
Practical information on hemodialysis, hemofiltration, peritoneal dialysis and apheresis is featured in this journal. Recognizing the critical importance of equipment and procedures, particular emphasis has been placed on reports, drawn from a wide range of fields, describing technical advances and improvements in methodology. Papers reflect the search for cost-effective solutions which increase not only patient survival but also patient comfort and disease improvement through prevention or correction of undesirable effects. Advances in vascular access and blood anticoagulation, problems associated with exposure of blood to foreign surfaces and acute-care nephrology, including continuous therapies, also receive attention. Nephrologists, internists, intensivists and hospital staff involved in dialysis, apheresis and immunoadsorption for acute and chronic solid organ failure will find this journal useful and informative. ''Blood Purification'' also serves as a platform for multidisciplinary experiences involving nephrologists, cardiologists and critical care physicians in order to expand the level of interaction between different disciplines and specialities.
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