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Title: Patterns and mechanisms of artificial kidney failure during continuous renal replacement therapy
Authors: Zhang, L;Tanaka, A;Zhu, G;Baldwin, Ian;Eastwood, Glenn;Bellomo, Rinaldo
Issue Date: 2016
EDate: 2016
Citation: Blood Purification 2016, vol. 41(4) p. 254-263
Abstract: Background: We aimed to describe the previously unstudied relationship between circuit pressures and circuit clotting, here labeled as ‘artificial kidney failure' (AKF), in patients receiving continuous renal replacement therapy (CRRT). Methods: We performed an observational study of CRRT-treated critically ill patients to continuously record the multiple CRRT circuit pressures. Results: Three patterns of access outflow dysfunction (AOD) were also noted: severe, moderate and mild. Compared with circuits without AOD, circuits experiencing at least one AOD episode had shorter lifespans (14.2 ± 12.7 vs. 21.3 ± 16.5 h, p = 0.057). This effect was more obvious with moderate or severe AOD (8.7 ± 4.6 vs. 20.6 ± 15.7 h, p = 0.007). If any AOD events occurred within the first 4 h, the sensitivity and specificity in predicting early-immediate AKF were 53.4 and 94.4%, respectively. Conclusions: Early and intermediate AKF during CRRT is most likely dependent on AOD, which is a frequent event with variable severity.
DOI: 10.1159/000441968
Type: Journal Article
Subjects: Renal replacement therapy
Observational study
Kidneys, artificial
Appears in Collections:Journal articles

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