Utilización de las terapias de depuración extracorpórea en los Servicios de Medicina Intensiva de Cataluña (España)

Objective: To assess the indications, settings and techniques used in renal replacement therapy (RRT) in Intensive Care Units (ICUs). Study design: A prospective, multicenter observational study was carried out. Setting: Intensive Care Units. Patients: All patients admitted to ICUs during the two-month study period in 2011 who required RRT. Interventions: None. Variables of interest: Patient demographic characteristics, baseline clinical data, RRT technique and materials used. Results: Thirty-three patients were analyzed. RRT was started within the first 24. hours after ICU admission in 17 of the 33 patients (52%). At the start of RRT, 18% of the patients (n. =. 6) presented grade R on the RIFLE acute kidney injury (AKI) scale. The most common disorder associated with AKI was multiple organ dysfunction syndrome (64%; n. =. 21). At the start of RRT, most patients (76%; n. =. 25) presented hemodynamic instability, while the remaining 24% (n. =. 8) were considered hemodynamically stable. The most common RRT technique in hemodynamically stable patients was continuous renal replacement therapy (CRRT) (63%; n. =. 5). CRRT was the technique of choice in all 25 of the hemodynamically unstable patients (100%). Anticoagulation was used in 55% (n. =. 18) of the patients. In most cases (61%, n. =. 20), RRT was administered through the right femoral vein. In 84% (n. =. 28) of the patients, the ultrafiltration effluent flow rate was ≤ 35. ml/kg/h. Conclusions: The ICU physicians in this study followed current RRT guidelines. CRRT was preferred over intermittent renal replacement therapy, regardless of patient hemodynamic status.