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The effect of specialized continuous renal replacement therapy team in acute kidney injury patients treatment

 Youn Kyung Kee  ;  Eun Jin Kim  ;  Kyoung Sook Park  ;  Seung Gyu Han  ;  In Mee Han  ;  Chang Yun Yoon  ;  Eunyoung Lee  ;  Young Su Joo  ;  Dae Young Kim  ;  Mi Jung Lee  ;  Jung Tak Park  ;  Seung Hyeok Han  ;  Tae-Hyun Yoo  ;  Beom Seok Kim  ;  Shin-Wook Kang  ;  Kyu Hun Choi  ;  Hyung Jung Oh 
 YONSEI MEDICAL JOURNAL, Vol.56(3) : 658-665, 2015 
Journal Title
Issue Date
Acute Kidney Injury/mortality ; Acute Kidney Injury/therapy* ; Adult ; Aged ; Aged, 80 and over ; Biomarkers ; Critical Illness/mortality* ; Critical Illness/therapy ; Female ; Humans ; Intensive Care Units ; Kaplan-Meier Estimate ; Kidney Failure, Chronic/therapy* ; Male ; Middle Aged ; Patient Care Team ; Proportional Hazards Models ; Renal Replacement Therapy/methods* ; Retrospective Studies ; Time Factors ; Treatment Outcome
28-day mortality ; SCT management ; acute kidney injury ; continuous renal replacement therapy
PURPOSE: Continuous renal replacement therapy (CRRT) has been established for critically ill acute kidney injury (AKI) patients. In addition, some centers consist of a specialized CRRT team (SCT) with physicians and nurses. To our best knowledge, however, ona a few studies have yet been carried out on the superiority of SCT management.
MATERIALS AND METHODS: A total of 551 patients, who received CRRT between January 2008 and March 2009, were divided into two groups based on the controller of CRRT. The impact of the CRRT management on 28-day mortality was compared between two groups by Kaplan-Meier curve and Cox analysis.
RESULTS: During the study period, the number of filters used, down-time per day, and intensive care unit length of day were significantly higher in non-SCT group than in SCT group (6.2 hrs vs. 5.0 hrs, p=0.042; 5.0 hrs vs. 3.8 hrs, p<0.001; 27.5 days vs. 21.1 days, p=0.027, respectively), while net ultrafiltration rate was significantly lower in non-SCT group than SCT group (28.0 mL/kg/hr vs. 29.5 mL/kg/hr, p=0.043, respectively). In addition, 28-day mortality rate was significantly lower in SCT group than with non-SCT group (p=0.031). Moreover, Cox regression analysis showed that 28-day mortality rate was significantly lower in SCT control group, even after adjusting for age, gender, severity scores, biomarkers, risk, injury, failure, loss, and end-stage renal disease, and contributing factors (hazard ratio 0.91, p=0.046).
CONCLUSION: A well-trained CRRT team could be beneficial for mortality improvement of AKI patients requiring CRRT.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Shin Wook(강신욱) ORCID logo https://orcid.org/0000-0002-5677-4756
Kee, Youn Kyung(기연경)
Kim, Beom Seok(김범석) ORCID logo https://orcid.org/0000-0002-5732-2583
Kim, Eun Jin(김은진)
Park, Kyoung Sook(박경숙)
Park, Jung Tak(박정탁) ORCID logo https://orcid.org/0000-0002-2325-8982
Oh, Hyung Jung(오형중)
Yoo, Tae Hyun(유태현) ORCID logo https://orcid.org/0000-0002-9183-4507
Yoon, Chang Yun(윤창연)
Lee, Mi Jung(이미정)
Lee, Eun Young(이은영)
Joo, Young Su(주영수) ORCID logo https://orcid.org/0000-0002-7890-0928
Choi, Kyu Hun(최규헌) ORCID logo https://orcid.org/0000-0003-0095-9011
Han, Seung Gyu(한승규)
Han, Seung Hyeok(한승혁) ORCID logo https://orcid.org/0000-0001-7923-5635
Han, In Mee(한인미)
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