Renal replacement therapy in intensive care units in KwaZulu-Natal Province, South Africa

Background Renal replacement therapy (RRT) is a scarce resource in southern Africa. Critically ill patients are at risk of developing acute kidney injury (AKI), which may require RRT. There are few data on the utilisation of RRT in southern African intensive care units (ICUs).Objectives To determine...

Full description

Saved in:
Bibliographic Details
Published in:The Southern African journal of critical care 2021-03, Vol.37 (1), p.21-26
Main Authors: Skinner, D L, De Vasconcellos, K, Wise, R, Kisten, T, Faurie, M, Hardcastle, T, Muckart, D J J
Format: Article
Language:English
Subjects:
Acute kidney injury
blood purification
Critical care
Dialysis
Medical equipment and supplies industry
Medical research
Medical test kit industry
Medicine, Experimental
Renal replacement therapy
Urea
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background Renal replacement therapy (RRT) is a scarce resource in southern Africa. Critically ill patients are at risk of developing acute kidney injury (AKI), which may require RRT. There are few data on the utilisation of RRT in southern African intensive care units (ICUs).Objectives To determine the indications for initiating RRT in critically ill patients in ICUs in KwaZulu-Natal, South Africa (SA) and to describe the methods and dosing of RRT.Methods A prospective observational study was performed to investigate the indications for initiating, methods and dosing of RRT among patients admitted to four ICUs in KwaZulu-Natal Province, SA. All adult patients were eligible for inclusion.Results A total of 108 patients who received RRT were included in the study. The most common reasons for initiation of RRT were a high/rising creatinine, high/rising urea, acidosis and fluid balance. The majority of the patients (79.6%; n=86) had three or more indications for RRT. A total of 353 intermittent haemodialysis/slow low-efficiency dialysis (IHD/SLED) sessions and 84 continuous renal replacement therapy (CRRT) sessions were recorded. The median (interquartile range (IQR)) CRRT dose was 25.8 (19.1 - 28.8) mL/kg/h. The median (IQR) urea reduction ratio for IHD/SLED was 32.4% (15.0 - 49.8).Conclusion Patients in this study had multiple indications for initiating RRT. The dosing of RRT was not optimal, with a wide range shown in CRRT, and the majority of patients did not achieve a urea reduction ratio (URR) >65%.
ISSN:1562-8264
2078-676X
DOI:10.7196/SAJCC.2021.v37i1.454