Defining and treating acute kidney injury patients in Brazilian intensive care units: Results from a cross-sectional nationwide survey.
The purpose of the study is to characterize the practices of Brazilian intensivists toward acute kidney injury (AKI) definition and management.



A cross-sectional survey was conducted among 36 Brazilian hospitals.



Of 731 ICU physicians invited to participate, 310 (42%) responded to the survey. Nearly half of the intensive care unit (ICU) physicians (146/310) do not apply AKIN and/or RIFLE definitions to their ICU patients. Most of the respondents prescribe intravenous fluids as a first-line therapeutic intervention for AKI patients. Although 38% of the surveyed physicians considered worsening of respiratory parameters to be the main criterion for stopping fluid infusion, only 15% considered daily net fluid balance as a criterion. Most of the respondents believed in the benefits of early renal replacement therapy (RRT) and considered worsening acidosis the most important criteria for starting early RRT. The main reason for a nephrologist referral was an urgently needed RRT.



Despite recent advances in AKI definition and management, most of the surveyed ICU physicians in Brazil have not incorporated them in their clinical practice. Important differences in the management of AKI patients were observed among Brazilian ICU physicians, which is relevant for educational interventions and future research.
Intensive Care Unit, Hospital Israelita Albert Einstein, São Paulo, Brazil. Electronic address: henrique.palomba@einstein.br.
Henrique
H
Palomba
Intensive Care Unit, Hospital Israelita Albert Einstein, São Paulo, Brazil. Electronic address: pedro.zanella@einstein.br.
Pedro Paulo Zanella
PP
do Amaral Campos
Intensive Care Unit, Hospital Israelita Albert Einstein, São Paulo, Brazil. Electronic address: thiago.correa@einstein.br.
Thiago Domingos
TD
Corrêa
Hospital Eduardo de Menezes, Fundação Hospitalar de Minas Gerais, Belo Horizonte, Brazil. Electronic address: fredbruzcarv@gmail.com.
Frederico Bruzzi
FB
de Carvalho
Intensive Care Unit, Centro Hospitalar Unimed, Joinville, Brazil. Electronic address: glauco.w@brturbo.com.br.
Glauco
G
Westphal
Hospital Geral Roberto Santos, Hospital Universitário Professor Edgars Santos, Salvador, Brazil. Electronic address: dimitrigusmao@gmail.com.
Dimitri
D
Gusmão
Hospital de Clinicas/Hospital Santa Rita-Complexo Hospitalar Santa Casa-Porto Alegre, Porto Alegre, Brazil. Electronic address: tlisboa@hotmail.com.
Thiago
T
Lisboa
Hospital Evangélico de Londrina, Hospital Universitário Regional do Norte do Paraná, Londrina, Brazil. Electronic address: cintiagrion@sercomtel.com.br.
Cintia Magalhães Carvalho
CM
Grion
Intensive Care Unit, Hospital Israelita Albert Einstein, São Paulo, Brazil. Electronic address: murillo.assuncao@einstein.br.
Murillo Santucci Cesar
MS
de Assunção
D058186:Acute Kidney Injury / Q000628:therapy*; D000328:Adult; D001938:Brazil; D003422:Critical Care; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D008297:Male; D010818:Practice Patterns, Physicians'; D017582:Renal Replacement Therapy / Q000379:methods; D011795:Surveys and Questionnaires
Acute kidney injury; Intensive care unit; Management; Renal insufficiency; Renal replacement therapy; Survey