Trends in the use of renal replacement therapy modality in intensive care unit: a 7 year study.
BACKGROUND
The use of renal replacement therapy (RRT) modality in the intensive care unit (ICU) depends primarily on provider preference and hospital resource. This study aims to describe the prevalence of RRT use and the trends in RRT modality use in the ICU over the past 7 years.


METHODS
All ICU admissions, including medical, cardiac, and surgical ICUs from 1 January 2007 to 31 December 2013, were included in this study. RRT use was defined as the use of intermittent hemodialysis (IHD) or continuous renal replacement therapy (CRRT) within a given ICU day. The RRT use was reported as the proportion of ICU days on each RRT modality divided by the total ICU days with RRT usage.


RESULTS
Over the course of this study (72,005 ICU admissions), 272,271 ICU days were generated. RRTs were used in 4110 ICU admissions (5.7%) and on 21,159 ICU days (7.8%). RRT use was 10,402 (49%) for IHD, and 10,954 (52%) for CRRT. The trend of IHD and CRRT use did not change from year 2007 to 2013. On ICU days with RRT, the choice of RRT modality was associated with the number of vasopressor use (p < 0.001). CRRT was more preferred on the ICU days with the increasing number of vasopressor use.


CONCLUSIONS
RRTs were used in about 6% of ICU admission. The use of IHD and CRRT was similar and did not change over 7 years. The choice of RRT modality mainly depended on the number of vasopressors used on ICU days with RRT.
a Division of Nephrology and Hypertension , Mayo Clinic , Rochester , MN , USA .|b Multidisciplinary Epidemiology and Translational Research in Intensive Care (METRIC), Mayo Clinic , Rochester , MN , USA , and.
Charat
C
Thongprayoon
a Division of Nephrology and Hypertension , Mayo Clinic , Rochester , MN , USA .
Wisit
W
Cheungpasitporn
b Multidisciplinary Epidemiology and Translational Research in Intensive Care (METRIC), Mayo Clinic , Rochester , MN , USA , and.|c Wichita Falls Family Practice Residency Program (WFFRP), North Central Texas Medical Foundation , Wichita Falls , TX , USA.
Adil H
AH
Ahmed
D058186:Acute Kidney Injury / Q000628:therapy*; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005544:Forecasting; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration*; D008297:Male; D008875:Middle Aged; D008910:Minnesota; D006435:Renal Dialysis / Q000379:methods; D017582:Renal Replacement Therapy / Q000706:statistics & numerical data* / Q000639:trends*
Continuous renal replacement therapydialysis; Intensive care unit; intermittent hemodialysis; renal replacement therapy