Evidence map›Paper›PMID 23265600›Full record

ReviewAdvances in chronic kidney disease2013

Antimicrobial dosing in acute renal replacement.

William H Fissell

Abstract readReview
In one paragraph

Review in Advances in chronic kidney disease, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed.

  1. Trial
  2. Article
  3. Review
  4. Article
  5. Review
  6. Review
  7. Observational
  8. Review
  9. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

1 author.

William H FissellDepartment of Nephrology and Hypertension, Vanderbilt University, Nashville, TN 37232, USA. william.fissell@vanderbilt.edu

Funding

Antibiotic Dosing in Continuous DialysisR21DK088045 · NIDDK · CLEVELAND CLINIC LERNER COM-CWRU · PI FISSELL, WILLIAM H · 2010 to 2011
$402k
NIDDK NIH HHS R21 DK088045
6 · The paper itself

Abstract

Acute kidney injury (AKI) is a common problem in hospitalized patients and is associated with significant morbidity and mortality. Two large trials showed no benefit from increased doses of renal replacement therapy (RRT) despite previous clinical data suggesting that increased clearance from RRT has beneficial effects. Since infection is the leading cause of death in AKI, my group and others hypothesized that increased RRT antibiotic clearance might create a competing morbidity. The data from my group, as well as those of other groups, show that many patients are underdosed when routine "1 size fits all" antibiotic dosing is used in patients with AKI receiving continuous RRT (CRRT). Here, concepts of drug distribution and clearance in AKI are briefly discussed and then 1 antibiotic (piperacillin) is discussed in depth to illustrate the challenges in applying the medical literature to clinical practice. The fact that published data on drug dosing in AKI and dialysis reflect the evolution of practice patterns and often do not apply to present prescribing habits is also discussed. A more general approach to drug dosing facilitates situation-specific prescribing by the nephrologist and critical care specialist.

Indexed as

Renal Replacement TherapyAcute Kidney InjuryAnti-Bacterial AgentsAntifungal AgentsBiological AvailabilityCritical CareCritical IllnessDrug Administration ScheduleDrug Dosage CalculationsHumansInactivation, MetabolicMetabolic Clearance RatePiperacillinPractice Guidelines as TopicTissue DistributionAnti-Bacterial AgentsAntifungal AgentsPiperacillin

Identifiers

PMID23265600
PMCPMC3807249

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.