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A national survey of renal replacement therapy prescribing practice for acute kidney injury in M alaysian intensive care units
Author(s) -
Jamal JanattulAin,
MatNor MohdBasri,
MohamadNor FarizSafhan,
Udy Andrew A,
Lipman Jeffrey,
Roberts Jason A
Publication year - 2014
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1111/nep.12276
Subject(s) - medicine , renal replacement therapy , acute kidney injury , intensive care medicine , acute care , intensive care , renal injury , emergency medicine , kidney , health care , economics , economic growth
Objectives To describe renal replacement therapy ( RRT ) prescribing practices in Malaysian intensive care units ( ICU ), and compare this with previously published data from other regions. Method A survey was sent to physicians responsible for prescribing RRT in major ICU throughout M alaysia. The questionnaire sought information on the physicians' background, and detailed information regarding RRT settings. Results Nineteen physicians from 24 sites throughout M alaysia responded to the survey (response rate 79.2%). Sixteen respondents were intensivists (84%), 2 were anaesthetists (11%) and one was a nephrologist (5%). The majority (58%) used continuous venovenous haemofiltration ( CVVH ) as the treatment of choice for acute kidney injury ( AKI ) in critically ill patients. RRT prescription was predominantly practitioner‐dependent (63%), while 37% reported use of a dedicated protocol. The mean blood flow rate and effluent flow rate used for continuous RRT ( CRRT ) were 188.9 ± 28.9 mL/min and 30.6 ± 4.7 mL/kg/h respectively. Replacement fluid solutions containing both lactate and bicarbonate were commonly used during CRRT , applied both pre‐ and post‐dilution. Conclusion CRRT was the first‐choice modality used to treat AKI in critically ill patients. CVVH was the most common CRRT technique used, while other RRT modalities were used less frequently. Overall, RRT practices were similar to those observed in other regions, although the modality and settings used were slightly different, likely due to local availability.