Increase of continuous treatments and regional citrate anticoagulation during renal replacement therapy in the ICUs of the North-West of Italy from 2007 to 2015. in Minerva urology and nephrology / Minerva Urol Nephrol. 2023 Jun;75(3):388-397. doi: 10.23736/S2724-6051.22.04699-7. Epub 2022 Mar 11.

2023
ASL Città di Torino
ASL Vercelli
ASL Asti
ASL Torino 4
ASL VCO
ASL Cuneo 1
ASL Cuneo 2
AO Ordine Mauriziano
AOU San Luigi di Orbassano
AO Cuneo
AOU Città della Salute di Torino
ASL Alessandria
AOU Alessandria
ASL Novara

Tipo pubblicazione

Journal Article

Autori/Collaboratori (49)Vedi tutti...

Roccatello D
Unit of Nephrology and Dialysis, Santa Croce e Carle Hospital, Cuneo, Italy.
Biancone L
Unit of Nephrology and Dialysis, S.S. Trinità Hospital, Borgomanero, Novara, Italy.
Cusinato S
Unit of Nephrology and Dialysis, SS Antonio e Biagio Hospital, Alessandria, Italy.

et alii...

Abstract

BACKGROUND: Few reports have addressed the change in renal replacement therapy (RRT) management in the Intensive care Units (ICUs) over the years in western countries. This study aims to assess the trend of dialytic practice in a 4.5-million population-based study of the northwest of Italy. METHODS: A nine-year survey covering all the RRT provided in the ICUs. Consultant nephrologists of the 26 Nephrology and Dialysis centers reported their activities in the years 2007, 2009, 2012, and 2015. RESULTS: From 2007 to 2015 the patients treated increased from 1042 to 1139, and the incidence of RRT from 254 to 263 cases/10^6 inhabitants. The workload for dialysis center was higher in the larger hub hospitals. RRT for acute kidney injury (AKI), continuation of treatment in chronically dialyzed patients, or extrarenal indications accounted for about the stable rate of 70, 25 and 5% of all RRT sessions, respectively. Continuous modality days increased from 2731 days (39.5%) in 2007 to 5076 (70.6%) in 2015, when the continuous+prolonged treatment days were 6880/7196 (95.6% of total days). As to RRT timing, in 2015 only the classical clinical criteria, and no K-DIGO stage were adopted by most Centers. As to RRT interruption, in 2015 urine volume was the first criterion. Implementation of citrate anticoagulation (RCA) for RRT patients significantly increased from 2.8% in 2007 to 30.9% in 2015, when it was applied in all 26 Centers. CONCLUSIONS: From 2007 to 2015, current practice has changed towards shared protocols, with increasing continuous modality and RCA implementation.

Accesso banca dati bibliografica

PMID : 35274902

DOI : 10.23736/S2724-6051.22.04699-7

Keywords

Anticoagulants; Italy; Citrates; Intensive Care Units; Renal Replacement Therapy/methods; Citric Acid; Humans; Renal Dialysis;