• 作者：M.E. Herrera-Gutié ; rrez^a ; ^{mehguci@gmail.com} ; G. Seller-Pé ; rez^a ; J. Maynar-Moliner^b ; J.Á ; . Sá ; nchez-Izquierdo Riera^c ; los investigadores del estudio COFRADE^&loz ;
• 关键词：Disfunció ; n renal aguda ; Depuració ; n extrarrenal ; Acute Dialysis Quality Initiative ; Acute Kidney Injury Network ; Prevenció ; n
• 刊名：Medicina Intensiva
• 出版年：2012
• 期刊代码：pca255_02105691
• 类别：med
• 出版时间：May, 2012
• 卷：36
• 期：4
• 页码：264-269
• 文件大小：395 K

Objective

To evaluate variability in the detection and prevention of acute kidney injury (AKI) in the intensive care unit (ICU), and application of the international recommendations in this field (Acute Dialysis Quality Initiative [ADQI] and Acute Kidney Injury Network [AKIN]).

Design

A prospective, observational, multicenter study.

Setting

A total of 42 ICUs in 32 hospitals (78%in third level hospitals and 70.7%general units) recruited for a study on the prevalence of AKI (COFRADE).

Interventions

Survey.

Variables

Aspects related to AKI detection and prevention and renal replacement therapy protocols.

Results

The method used for estimating glomerular filtration rate was serum creatinine in 36.6%, creatinine clearance in 41.5%and equations in 22%; none reported using cystatin-C. Only 39.1%ICUs acknowledged the use of stratification systems (13 RIFLE and 3 AKIN).

A total of 48.8%ICUs had no written protocols for AKI prevention, 31.7%reported using them only for contrast nephropathy, 7.3%for nephrotoxic drugs and 12.2%for both.

In contrast, 63.4%participants had written protocols for renal replacement therapy, 70.7%had implemented a training program, and 53.7%had some method for adjusting doses of drugs when on renal replacement therapy.

Conclusions

We observed important variability regarding diagnostic criteria and prevention of AKI in Spanish ICUs, the application of ADQI or AKIN recommendations still being low in our units. Renal replacement therapy seems to generate more concern among our intensivists than AKI management.