Variabilidad en los criterios de definición y métodos de detección de la disfunción renal en las unidades de cuidados intensivos ¿se aplican los consensos internacionales para el diagnóstico de la disfunción renal?. [artículo]
Por: Sánchez-Izquierdo Riera, José Ángel [Medicina Intensiva].
Colaborador(es): Servicio de Medicina Intensiva.
Editor: Medicina Intensiva, 2012Descripción: 36(4):264-9.Recursos en línea: Solicitar documento Resumen: To evaluate variability in the detection and prevention of acute kidney injury (AKI) in the intensive care unit (ICU), and application of the international recommendations in this field (Acute Dialysis Quality Initiative [ADQI] and Acute Kidney Injury Network [AKIN]). DESIGN: A prospective, observational, multicenter study. SETTING: A total of 42 ICUs in 32 hospitals (78% in third level hospitals and 70.7% general units) recruited for a study on the prevalence of AKI (COFRADE). INTERVENTIONS: Survey. VARIABLES: Aspects related to AKI detection and prevention and renal replacement therapy protocols. RESULTS: The method used for estimating glomerular filtration rate was serum creatinine in 36.6%, creatinine clearance in 41.5% and equations in 22%; none reported using cystatin-C. Only 39.1% ICUs acknowledged the use of stratification systems (13 RIFLE and 3 AKIN). A total of 48.8% ICUs had no written protocols for AKI prevention, 31.7% reported using them only for contrast nephropathy, 7.3% for nephrotoxic drugs and 12.2% for both. In contrast, 63.4% participants had written protocols for renal replacement therapy, 70.7% had implemented a training program, and 53.7% had some method for adjusting doses of drugs when on renal replacement therapy. CONCLUSIONS: We observed important variability regarding diagnostic criteria and prevention of AKI in Spanish ICUs, the application of ADQI or AKIN recommendations still being low in our units. Renal replacement therapy seems to generate more concern among our intensivists than AKI management.Tipo de ítem | Ubicación actual | Signatura | Estado | Fecha de vencimiento |
---|---|---|---|---|
Artículo | PC3513 (Navegar estantería) | Disponible |
Formato Vancouver:
Herrera Gutiérrez ME, Seller Pérez G, Maynar Moliner J, Sánchez- Izquierdo Riera JÁ; Los Investigadores del Estudio COFRADE. Variabilidad en los criterios de definición y métodos de detección de la disfunción renal en las unidades de cuidados intensivos ¿se aplican los consensos internacionales para el diagnóstico de la disfunción renal?. Med Intensiva. 2012 May;36(4):264-9.
PMID: 22153932
Contiene 26 referencias
To evaluate variability in the detection and prevention of acute kidney injury (AKI) in the intensive care unit (ICU), and application of the international recommendations in this field (Acute Dialysis Quality Initiative [ADQI] and Acute Kidney Injury Network [AKIN]).
DESIGN: A prospective, observational, multicenter study.
SETTING: A total of 42 ICUs in 32 hospitals (78% in third level hospitals and 70.7% general units) recruited for a study on the prevalence of AKI (COFRADE).
INTERVENTIONS: Survey.
VARIABLES: Aspects related to AKI detection and prevention and renal replacement therapy protocols.
RESULTS: The method used for estimating glomerular filtration rate was serum creatinine in 36.6%, creatinine clearance in 41.5% and equations in 22%; none reported using cystatin-C. Only 39.1% ICUs acknowledged the use of stratification systems (13 RIFLE and 3 AKIN). A total of 48.8% ICUs had no written protocols for AKI prevention, 31.7% reported using them only for contrast nephropathy, 7.3% for nephrotoxic drugs and 12.2% for both. In contrast, 63.4% participants had written protocols for renal replacement therapy, 70.7% had implemented a training program, and 53.7% had some method for adjusting doses of drugs when on renal replacement therapy.
CONCLUSIONS: We observed important variability regarding diagnostic criteria and prevention of AKI in Spanish ICUs, the application of ADQI or AKIN recommendations still being low in our units. Renal replacement therapy seems to generate more concern among our intensivists than AKI management.
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