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Title: Evaluation of urea and creatinine change during continuous renal replacement therapy: effect of blood flow rate.
Austin Authors: Fealy, Nigel G ;Aitken, Leanne;du Toit, Eugene;Bailey, Michael;Baldwin, Ian C 
Affiliation: Department of Intensive Care Medicine, Austin Health, Heidelberg, Victoria, Australia
School of Nursing and Midwifery, Griffith University, Brisbane, Australia
School of Medical Science, Griffith University, Gold Coast, Australia
Australian and New Zealand Intensive Care Research Centre, Department of Epidemiology and Preventative Medicine, Melbourne, Australia
Issue Date: Mar-2018
Publication information: Critical Care and Resuscitation 2018; 20(1): 41-47
Abstract: To determine if faster blood flow rate (BFR) has an effect on solute maintenance in continuous renal replacement therapy. Prospective randomised controlled trial. 24-bed, single centre, tertiary level intensive care unit. Critically ill adults requiring continuous renal replacement therapy (CRRT). Patients were randomised to receive one of two BFRs: 150 mL/min or 250 mL/min. Changes in urea and creatinine concentrations (percentage change from baseline) and delivered treatment for each 12-hour period were used to assess solute maintenance. 100 patients were randomised, with 96 completing the study (49 patients, 150 mL/min; 47 patients, 250 mL/min). There were a total of 854 12-hour periods (421 periods, 150 mL/min; 433 periods, 250 mL/ min). Mean hours of treatment per 12 hours was 6.3 hours (standard deviation [SD], 3.7) in the 150 mL/min group, and 6.7 hours (SD, 3.9) in the 250 mL/min group (P = 0.6). There was no difference between the two BFR groups for change in mean urea concentration (150 mL/min group, -0.06%; SD, 0.015; v 250 mL/min group, -0.07%; SD, 0.01; P = 0.42) or change in mean creatinine concentration (150 mL/min, -0.05%; SD, 0.01; v 250 mL/min, -0.08%; SD, 0.01; P = 0.18). Independent variables associated with a reduced percentage change in mean serum urea and creatinine concentrations were low haemoglobin levels (-0.01%; SD, 0.005; P = 0.002; and 0.01%; SD, 0.005; P = 0.006, respectively) and less hours treated (-0.023%; SD, 0.001; P = 0.000; and -0.02%; SD, 0.002; P = 0.001, respectively). No effect for bodyweight was found. Faster BFR did not affect solute control in patients receiving CRRT; however, differences in urea and creatinine concentrations were influenced by serum haemoglobin and hours of treatment.
PubMed URL: 29458320
PubMed URL:
ISSN: 1441-2772
Type: Journal Article
Appears in Collections:Journal articles

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