scholarly journals Haemodynamically Unstable Acute Kidney Injury Patients Treated with Sustained Low Efficiency Dialysis: Outcome in an ICU of Bangladesh

2017 ◽  
Vol 42 (1) ◽  
pp. 14-20
Author(s):  
Kaniz Fatema ◽  
Mohammad Omar Faruq
Keyword(s):  
Acute Kidney Injury ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
De Novo ◽  
Tertiary Care ◽  
Kidney Injury ◽  
Cost Effective ◽  
Apache Ii Score ◽  
Care Hospital ◽  
Low Efficiency

Acute kidney injury (AKI) is a risk factor for increased mortality in critically ill patients. Sustained low efficiency dialysis (SLED) is a new approach in renal replacement therapy (RRT) and it combines the advantages of continuous renal replacement therapy (CRRT) and intermittent haemodialysis (HD). The study was aimed to evaluate the outcome of the hae-modynamically unstable patients with AKI in Bangladesh who were treated with SLED. So far this is the first reported study on SLED in intensive care unit (ICU) in Bangladesh. This quasi-experimental study was conducted in a 10-bed adult ICU of a tertiary care hospital in Bangladesh from June 2012 to May 2013. A total of 153 sessions of SLED were performed on 43 AKI patients. Mean age of the patients was 60.12 ± 15.57 years with male preponder-ance (67.4% were male). Mean APACHE II score was 26.88 ± 6.25. Fourteen patients (32.55%) had de novo AKI. Twenty nine patients (67.4%) had chronic kidney disease (CKD) with baseline mean serum creatinine 2.56 mg/dl, but did not require any RRT before admis-sion in ICU. After giving SLED, AKI of the study patients were completely resolved in 27.9%. Some forty two percent patients became dialysis dependant and 30.23% patients died. Patients who had AKI on CKD became dialysis dependant more often than the patients with de novo AKI (p <0.01). Mortality rate was significantly higher in patients who were on inotrope support (p= 0.017). Otherwise, there was no relation of 28 day mortality with age, prior renal function and mechanical ventilator requirement (p>0.05). Thus, SLED is an excellent renal replacement therapy for the haemodynamically unstable AKI patients of ICU. It is also cost-effective compared to CRRT.

scholarly journals Prevalence of acute kidney injury and use of renal replacement therapy in intensive care unit patients in Indonesia

2020 ◽  
Author(s):  
Jonny Jonny ◽  
Moch Hasyim ◽  
Vedora Angelia ◽  
Ayu Nursantisuryani Jahya ◽  
Lydia Permata Hilman ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Renal Replacement Therapy ◽  
Southeast Asia ◽  
Replacement Therapy ◽  
Kidney Injury ◽  
Apache Ii Score ◽  
Intermittent Hemodialysis ◽  
Predictability Score ◽  
Epidemiology Data ◽  
Low Efficiency

Abstract Background : Currently, there is limited epidemiology data on acute kidney injury (AKI) from Southeast Asia, especially from Indonesia which is one of the biggest countries in Southeast Asia. Therefore, we assessed the prevalence of AKI and the utilization of renal replacement therapy (RRT) in Indonesia. Methods : Demographic and clinical data were collected from 952 ICU participants. The participants were categorized into AKI and non-AKI groups. The participants were further classified according to the 3 different stages of AKI as per the Kidney Disease Improving Global Outcome (KDIGO) criteria. We then assessed the Acute Physiology and Chronic Health Evaluation (APACHE) II score of AKI and non-AKI participants. RRT modalities were listed according to the number of times the procedures were carried out. Results : Overall incidence of AKI was 43%. The participants were divided into three groups based on the AKI stages: 18.5 % had stage 1, 33% had stage 2, and 48.5 % had stage 3. The use of mechanical ventilation was higher among the participants with AKI compared to the non-AKI participants. Also, AKI participants had higher average APACHE score compared to the non-AKI participants (16.5 vs 9.9). Among the AKI participants, 24.6% required RRT. The most common RRT modalities were intermittent hemodialysis (69.4%), followed by slow low-efficiency dialysis (22.1%), continuous renal replacement therapy (4.2%), and peritoneal dialysis (1.1%). Conclusions : This study showed that AKI is a common problem in the Indonesian ICU and had a high mortality rate. We strongly believe that identification of the risk factors associated with AKI will help us to develop a predictability score for AKI so we can prevent and improve AKI outcome in the future.

Indications for Dialysis in Acute Kidney Injury

2020 ◽  
Author(s):  
Ankit Patel ◽  
Kenneth B Christopher
Keyword(s):  
Acute Kidney Injury ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
High Efficiency ◽  
Kidney Injury ◽  
Intermittent Hemodialysis ◽  
Continuous Venovenous Hemofiltration ◽  
Continuous Venovenous Hemodialysis ◽  
Low Efficiency ◽  
The Impact

Renal replacement therapy (RRT) can be used to support patient’s kidney function in cases of acute kidney injury (AKI). However, timing, modality, and dosing of RRT continue to remain in question. Recent studies have begun to provide data to help guide clinicians on when to initiate RRT, what form of RRT to use ranging from continuous venovenous hemofiltration (VVH) to intermittent hemodialysis, and the impact of high versus low-intensity dosing. Additionally, the risks associated with temporary vascular access with regard to thrombosis and infection, the impact of high efficiency and flux versus low efficiency and flux membranes, and options for anticoagulation in RRT for AKI are also discussed. This review contains 75 references.  Key words: acute kidney injury, chronic kidney disease, continuous venovenous hemofiltration, continuous venovenous hemodialysis, renal replacement therapy, venovenous hemofiltration, 

scholarly journals Acute kidney injury incidence and acute renal replacement modality in intensive care unit patients in Indonesia: A result from Southeast Asia-Acute Kidney Injury Study

2020 ◽  
Author(s):  
Jonny Jonny ◽  
Moch Hasyim ◽  
Vedora Angelia ◽  
Ayu Nursantisuryani Jahya ◽  
Lydia Permata Hilman ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
Renal Replacement Therapy ◽  
Southeast Asia ◽  
Replacement Therapy ◽  
Kidney Injury ◽  
Apache Ii Score ◽  
Icu Patients ◽  
Three Stages

Abstract Background : Currently, there is limited data of large databases of acute kidney injury (AKI) epidemiology from Southeast Asia, especially in Indonesia, the biggest countries in. Therefore, we aimed to provide demographic data of intensive care unit (ICU) patients with AKI and the utilization of renal replacement therapy (RRT) in Indonesia. Methods : We collected demographic and clinical data from 952 ICU patients. Patients were classified into AKI and non-AKI. AKI was classified according to the Kidney Disease Improving Global Outcome (KDIGO) criteria in three stages. We then assess the Acute Physiology and Chronic Health Evaluation (APACHE) II score of AKI and non-AKI patients. RRT modalities were listed down by the number of procedures conducted. Results : Overall incidence of AKI was 43%, distributed among three stages: 18.5 % stage 1, 33% stage 2, 48.5 % stage 3. Patients developing AKI need mechanical ventilation more often in comparison with non-AKI. Patients with AKI have an average APACHE score of 16.5, while non-AKI patients have an average score of 9.9. Among AKI patients, 24.6% requires RRT. The most common RRT modalities were intermittent hemodialysis (69.4%), followed by slow low efficiency dialysis (22.1%), continuous renal replacement therapy (4.2%), and peritoneal dialysis (1.1%). Conclusions: This study showed that AKI is a common problem in Indonesian ICU with containing a high mortality rate. We strongly believe that identification the risk factor of AKI will provide the opportunity to develop the predictability score for AKI prevention and finally improve AKI outcome.

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