Dosing patterns for continuous renal replacement therapy at a large academic medical center in the United States.
OBJECTIVE
We sought to retrospectively review the dosing patterns of continuous renal replacement therapy (CRRT) in patients with acute renal failure (ARF) and determine their actual delivered dosage of CRRT.


METHODS
Computerized records of patients (n = 115) who received CRRT for ARF at a single, large, academic, tertiary care hospital from September 1, 1999 through August 31, 2000 were reviewed. The delivered dose of CRRT for each patient/day was calculated from the hourly effluent flow rate, the patient's weight, and the duration (in hours) of CRRT for that day. A mean effluent flow rate (in L/h) for each patient was then calculated.


RESULTS
The average number of hours/day on CRRT was 16.1 +/- 3.53 (mean +/- SD), with a mean flow rate (averaged over 24 h) of 1.36 +/- 0.31 L/h. The mean CRRT dose prescribed for these patients was 24.46 +/- 6.73 mL/Kg/h, but the mean dose delivered was only 16.55 +/- 5.41 mL/Kg/h (68% of the prescribed dose, P <.000001).


CONCLUSIONS
Many patients are prescribed low doses of CRRT. Furthermore, the dose delivered is considerably lower than that prescribed. Methods and procedures to extend CRRT system life may improve the dose delivery.
Venkataraman
Ramesh
R
Department of Critical Care Medicine, University of Pittsburgh School of Medicine and Veteran's Affairs Pittsburgh Healthcare System, Pittsburgh, PA 15261, USA.
Kellum
John A
JA
Palevsky
Paul
P
D000046:Academic Medical Centers; D058186:Acute Kidney Injury / Q000628:therapy*; D000328:Adult; D000368:Aged; D003422:Critical Care / Q000379:methods; D005260:Female; D015312:Hemodialysis Solutions / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D010414:Pennsylvania; D017582:Renal Replacement Therapy / Q000379:methods*; D012189:Retrospective Studies; D014882:Water-Electrolyte Balance
D015312:Hemodialysis Solutions