For Publishers
DiscoveryMetadataPeer reviewHostingPublishing
For Researchers
JoinPublishReviewCollect
Register
Blog
About
Search
Advanced search
My ScienceOpen
Search
For Publishers
For Researchers
Blog
About
21
views
123
references
 Top references
cited by
10
    
0 reviews
 Review
0
comments
 Comment
0
recommends
+1 Recommend
0 collections
    0
    shares
      261
      similar
       All similar
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Renal Support for Acute Kidney Injury in the Developing World

      brief-report

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          There is wide variation in the management of acute kidney injury (AKI) and the practice of renal replacement therapy (RRT) around the world. Clinicians in developing countries face additional challenges due to limited resources, reduced availability of trained staff and equipment, cultural and socioeconomic aspects, and administrative and governmental barriers. In this article, we report the consensus recommendations from the 18th Acute Dialysis Quality Initiative conference in Hyderabad, India. We provide the minimal requirements for provision of acute RRT in developing countries, including patient selection, choice of RRT modality and monitoring, transition, and termination of acute RRT. We also discuss areas of uncertainty and propose themes for future research. These recommendations can serve as a foundation for clinicians to implement renal support for AKI in low resource settings.

          Related collections

          Most cited references123

          • Record: found
          • Abstract: found
          • Article: not found

          Continuous venovenous haemodiafiltration versus intermittent haemodialysis for acute renal failure in patients with multiple-organ dysfunction syndrome: a multicentre randomised trial.

          K Beauregard, Christophe Vinsonneau, Christophe Camus … (2006)
          Whether continuous renal replacement therapy is better than intermittent haemodialysis for the treatment of acute renal failure in critically ill patients is controversial. In this study, we compare the effect of intermittent haemodialysis and continuous venovenous haemodiafiltration on survival rates in critically ill patients with acute renal failure as part of multiple-organ dysfunction syndrome. Our prospective, randomised, multicentre study took place between Oct 1, 1999, and March 3, 2003, in 21 medical or multidisciplinary intensive-care units from university or community hospitals in France. Guidelines were provided to achieve optimum haemodynamic tolerance and effectiveness of solute removal in both groups. The two groups were treated with the same polymer membrane and bicarbonate-based buffer. 360 patients were randomised, and the primary endpoint was 60-day survival based on an intention-to-treat analysis. Rate of survival at 60-days did not differ between the groups (32% in the intermittent haemodialysis group versus 33% in the continuous renal replacement therapy group [95 % CI -8.8 to 11.1,]), or at any other time. These data suggest that, provided strict guidelines to improve tolerance and metabolic control are used, almost all patients with acute renal failure as part of multiple-organ dysfunction syndrome can be treated with intermittent haemodialysis.
          Article 0 comments Cited 152 times – based on 0 reviews     Review now
            Bookmark
            • Record: found
            • Abstract: found
            • Article: found
            Is Open Access

            Sustaining reductions in catheter related bloodstream infections in Michigan intensive care units: observational study

            Peter Pronovost, Christine A Goeschel, Elizabeth Colantuoni … (2010)
            Objectives To evaluate the extent to which intensive care units participating in the initial Keystone ICU project sustained reductions in rates of catheter related bloodstream infections. Design Collaborative cohort study to implement and evaluate interventions to improve patients’ safety. Setting Intensive care units predominantly in Michigan, USA. Intervention Conceptual model aimed at improving clinicians’ use of five evidence based recommendations to reduce rates of catheter related bloodstream infections rates, with measurement and feedback of infection rates. During the sustainability period, intensive care unit teams were instructed to integrate this intervention into staff orientation, collect monthly data from hospital infection control staff, and report infection rates to appropriate stakeholders. Main outcome measures Quarterly rate of catheter related bloodstream infections per 1000 catheter days during the sustainability period (19-36 months after implementation of the intervention). Results Ninety (87%) of the original 103 intensive care units participated, reporting 1532 intensive care unit months of data and 300 310 catheter days during the sustainability period. The mean and median rates of catheter related bloodstream infection decreased from 7.7 and 2.7 (interquartile range 0.6-4.8) at baseline to 1.3 and 0 (0-2.4) at 16-18 months and to 1.1 and 0 (0.0-1.2) at 34-36 months post-implementation. Multilevel regression analysis showed that incidence rate ratios decreased from 0.68 (95% confidence interval 0.53 to 0.88) at 0-3 months to 0.38 (0.26 to 0.56) at 16-18 months and 0.34 (0.24-0.48) at 34-36 months post-implementation. During the sustainability period, the mean bloodstream infection rate did not significantly change from the initial 18 month post-implementation period (−1%, 95% confidence interval −9% to 7%). Conclusions The reduced rates of catheter related bloodstream infection achieved in the initial 18 month post-implementation period were sustained for an additional 18 months as participating intensive care units integrated the intervention into practice. Broad use of this intervention with achievement of similar results could substantially reduce the morbidity and costs associated with catheter related bloodstream infections.
            Article 0 comments Cited 116 times – based on 0 reviews     Review now
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Daily hemodialysis and the outcome of acute renal failure.

              V. Lang, Rainald Fischer, Helmut Schiffl (2002)
              Intermittent hemodialysis is widely used as renal-replacement therapy in patients with acute renal failure, but an adequate dose has not been defined. We performed a prospective study to determine the effect of daily intermittent hemodialysis, as compared with conventional (alternate-day) intermittent hemodialysis, on survival among patients with acute renal failure. A total of 160 patients with acute renal failure were assigned to receive daily or conventional intermittent hemodialysis. Survival was the primary end point of the study. The duration of acute renal failure and the frequency of therapy-related complications were secondary end points. The two study groups were similar with respect to age, sex, cause and severity of acute renal failure, medical or surgical intensive care setting, and the score on the Acute Physiology, Age, and Chronic Health Evaluation. Daily hemodialysis resulted in better control of uremia, fewer hypotensive episodes during hemodialysis, and more rapid resolution of acute renal failure (mean [+/-SD], 9+/-2 vs. 16+/-6 days; P=0.001) than did conventional hemodialysis. The mortality rate, according to the intention-to-treat analysis, was 28 percent for daily dialysis and 46 percent for alternate-day dialysis (P=0.01). In a multiple regression analysis, less frequent hemodialysis (on alternate days, as opposed to daily) was an independent risk factor for death. The high mortality rate among critically ill patients with acute renal failure who require renal-replacement therapy is related to both coexisting conditions and uremic damage to other organ systems. Intensive hemodialysis reduces mortality without increasing hemodynamically induced morbidity.
              Article 0 comments Cited 110 times – based on 0 reviews     Review now
                Bookmark
                All references

                Author and article information

                Contributors
                Rajeev A. Annigeri
                Journal
                Journal ID (nlm-ta): Kidney Int Rep
                Journal ID (iso-abbrev): Kidney Int Rep
                Title: Kidney International Reports
                Publisher: Elsevier
                ISSN (Electronic): 2468-0249
                Publication date PMC-release: 26 April 2017
                Publication date Collection: July 2017
                Publication date (Electronic): 26 April 2017
                Volume: 2
                Issue: 4
                Pages: 559-578
                Affiliations
                [1 ]Department of Nephrology, Apollo Hospitals, Chennai, India
                [2 ]Department of Nephrology & Critical Care, Guy’s & St Thomas’ Hospital, London, UK
                [3 ]Division of Nephrology, University of Alabama, Birmingham, Alabama, USA
                [4 ]Department of Nephrology, Instituto Nacional de Cardiologia, Mexico City, Mexico
                [5 ]Department of Medicine, Botucatu School of Medicine, Sao Paulo, Brazil
                [6 ]Division of Nephrology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
                [7 ]Reknown Nephrology Associates, Hyderabad, India
                [8 ]Division of Nephrology and Hypertension, Department of Medicine, University of California-San Diego, San Diego, California, USA
                Author notes
                [∗ ] Correspondence: Dr. Rajeev A. Annigeri, Apollo Hospitals, Department of Nephrology, 21, Greams Lane, Off Greams Road, Chennai, Tamil Nadu 600006, India.Apollo Hospitals, Department of Nephrology21, Greams Lane, Off Greams RoadChennaiTamil Nadu 600006India r_annigeri@ 123456yahoo.com drrajeevannigeri@ 123456hotmail.com
                Article
                Publisher ID: S2468-0249(17)30101-8
                DOI: 10.1016/j.ekir.2017.04.006
                PMC ID: 5678608
                SO-VID: 36a44e4c-f223-478c-ad4d-cdd0652c9958
                Copyright © © 2017 International Society of Nephrology. Published by Elsevier Inc.
                License:

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                Date received : 28 February 2017
                Date revision received : 10 April 2017
                Date accepted : 14 April 2017
                Categories
                Subject: Meeting Report

                Keywords: acute kidney injury,crrt,developing countries,dialysis,dose,ihd,modality,pd,renal support,resources,sled
                Data availability:
                Keywords: acute kidney injury, crrt, developing countries, dialysis, dose, ihd, modality, pd, renal support, resources, sled

                Comments

                Comment on this article

                scite_

                Similar content261

                See all similar

                Cited by10

                See all cited by

                Most referenced authors1,658

                See all reference authors