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Quenot JP, Amrouche I, Lefrant JY, et al. Renal Replacement Therapy for Acute Kidney Injury in French Intensive Care Units: A Nationwide Survey of Practices. Blood Purif. 2021;1-10doi: 10.1159/000518919.
Quenot, J. P., Amrouche, I., Lefrant, J. Y., Klouche, K., Jaber, S., Du Cheyron, D., Duranteau, J., Maizel, J., Rondeau, E., Javouhey, E., Gaillot, T., Robert, R., Dellamonica, J., Souweine, B., Bohé, J., Barbar, S. D., Sejourné, C., Vinsonneau, C. (2021). Renal Replacement Therapy for Acute Kidney Injury in French Intensive Care Units: A Nationwide Survey of Practices. Blood purification, 1-10. https://doi.org/10.1159/000518919
Quenot, Jean-Pierre, et al. "Renal Replacement Therapy for Acute Kidney Injury in French Intensive Care Units: A Nationwide Survey of Practices." Blood purification vol. (2021): 1-10. doi: https://doi.org/10.1159/000518919
Quenot JP, Amrouche I, Lefrant JY, Klouche K, Jaber S, Du Cheyron D, Duranteau J, Maizel J, Rondeau E, Javouhey E, Gaillot T, Robert R, Dellamonica J, Souweine B, Bohé J, Barbar SD, Sejourné C, Vinsonneau C. Renal Replacement Therapy for Acute Kidney Injury in French Intensive Care Units: A Nationwide Survey of Practices. Blood Purif. 2021 Nov 04;1-10. doi: 10.1159/000518919. Epub 2021 Nov 04. PMID: 34736254.
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Blood Purif. 2021 Nov 04;1-10. doi: 10.1159/000518919. Epub 2021 Nov 04.

Renal Replacement Therapy for Acute Kidney Injury in French Intensive Care Units: A Nationwide Survey of Practices.

Blood purification

Jean-Pierre Quenot, Idris Amrouche, Jean-Yves Lefrant, Kada Klouche, Samir Jaber, Damien Du Cheyron, Jacques Duranteau, Julien Maizel, Eric Rondeau, Etienne Javouhey, Théophile Gaillot, René Robert, Jean Dellamonica, Bertrand Souweine, Julien Bohé, Saber Davide Barbar, Caroline Sejourné, Christophe Vinsonneau,

Affiliations

  1. Service de Médecine Intensive-Réanimation, CHU Dijon Bourgogne, Dijon, France.
  2. Equipe Lipness, Centre de Recherche INSERM UMR1231, LabEx LipSTIC, Université de Bourgogne-Franche Comté, Dijon, France.
  3. INSERM CIC 1432, Module Epidémiologie Clinique, Université de Bourgogne-Franche Comté, Dijon, France.
  4. EA 2992 IMAGINE, Université de Montpellier, Montpellier, France.
  5. Pôle Anesthésie Réanimation Douleur Urgence, CHU, Nîmes, France.
  6. Intensive Care Unit, Anaesthesiology and Intensive Care Department, Lapeyronie Hospital University Hospital and INM University Montpellier, INSERM, Montpellier, France.
  7. Department of Anesthesia and Critical Care Medicine, University of Montpellier Saint Eloi Hospital, and PhyMedExp, University of Montpellier, INSERM, CNRS, Montpellier, France.
  8. BoReal Study Group, Medical Intensive Care Unit, Caen University Hospital, Caen, France.
  9. Anesthesia and Intensive Care Department, Hôpitaux Universitaires Paris Sud, Université Paris-Sud, Université Paris-Saclay, Hôpital de Bicêtre, Assistance Publique Hôpitaux de Paris (APHP), Le Kremlin-Bicêtre, France.
  10. BoReal Study Group, Medical Intensive Care Unit and EA7517, Amiens University Hospital, Amiens, France.
  11. Department of Nephrology and Transplantation, AP-HP, Hôpital Tenon, Paris, France.
  12. INSERM UMR-S 1155, Hospital Tenon, Paris, France.
  13. Urgences Néphrologiques et Transplantation Rénale, Sorbonne Université, Paris, France.
  14. Paediatric Intensive Care Unit, Hospices Civils de Lyon, University of Lyon, Lyon, France.
  15. Hospices Civils of Lyon, University Claude Bernard Lyon 1, Lyon, France.
  16. Service de Pédiatrie, Hôpital Sud, CHU de Rennes, Rennes, France.
  17. CIC-P Inserm 0203 Université Rennes, Rennes, France.
  18. Réanimation Médicale, CHU La Milétrie, Poitiers, France.
  19. Medical Intensive Care Unit, l'Archet Hospital, University Hospital of Nice, Nice, France.
  20. Service de Réanimation Médicale, CHU de Clermont-Ferrand, Clermont Ferrand, France.
  21. Service d'Anesthésie-Réanimation-Médecine Intensive, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre Bénite, France.
  22. Department of Anaesthesiology, Critical Care and Emergency Medicine, CHU Nïmes, University Montpellier, Nîmes, France.
  23. BoReal Study Group, Intensive Care Unit, Hôpital de Bethune, Bethune, France.

PMID: 34736254 DOI: 10.1159/000518919

Abstract

BACKGROUND: The frequency of acute kidney injury (AKI) can be as high as 50% in the intensive care unit (ICU). Despite the publication of national guidelines in France in 2015 for the use of RRT, there are no data describing the implementation of these recommendations in real-life.

METHODS: We performed a nationwide survey of practices from November 15, 2019, to January 24, 2020, in France. An electronic questionnaire based on the items recommended in the national guidelines was sent using an online survey platform, to the chiefs of all ICUs in France. The questionnaire comprised a section for the Department Chief about local organization and facilities, and a second section destined for individual physicians about their personal practices.

RESULTS: We contacted the Department Chief in 356 eligible ICUs, of whom 88 (24.7%) responded regarding their ICU organization. From these 88 ICUs, 232/285 physicians (82%) completed the questionnaire regarding individual practices. The practices reported by respondent physicians were as follows: intermittent RRT was first-line choice in >75% in a patient with single organ (kidney) failure at the acute phase, whereas continuous RRT was predominant (>75%) in patients with septic shock or multi-organ failure. Blood and dialysate flow for intermittent RRT were 200-300 mL/min and 400-600 mL/min, respectively. The dose of dialysis for continuous RRT was 25-35 mL/kg/h (65%). Insertion of the dialysis catheter was mainly performed by the resident under echographic guidance, in the right internal jugular vein. The most commonly used catheter lock was citrate (53%). The most frequently cited criterion for weaning from RRT was diuresis, followed by a drop in urinary markers (urea and creatinine).

CONCLUSION: This study shows a satisfactory level of reported compliance with French guidelines and recent scientific evidence among ICU physicians regarding initiation of RRT for AKI in the ICU.

© 2021 S. Karger AG, Basel.

Keywords: Acute kidney injury; Intensive care unit; Renal replacement therapy; Survey of practice

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