Evidence map›Paper›PMID 26298845›Full record

ArticleJournal of nephrology2016

Sustained low-efficiency extended dialysis (SLED) with single-pass batch system in critically-ill patients with acute kidney injury (AKI).

Renato A Caires, Regina C R M Abdulkader, Verônica T Costa E Silva, Gillene S Ferreira, Emmanuel A Burdmann, Luis Yu, Etienne Macedo

Abstract read
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Article in Journal of nephrology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing 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

8 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
  4. Review
  5. Article
  6. Prolonged intermittent renal replacement therapy in children.Pediatric nephrology (Berlin, Germany) · 2018
    Review
  7. Observational
  8. Article
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

7 authors.

Renato A CairesService of Nephrology, School of Medicine, University of Sao Paulo, Av. Doutor Arnaldo 251, Sao Paulo, SP, CEP: 01246-000, Brazil. renatoacaires@ig.com.br.
Regina C R M AbdulkaderService of Nephrology, School of Medicine, University of Sao Paulo, Av. Doutor Arnaldo 251, Sao Paulo, SP, CEP: 01246-000, Brazil.
Verônica T Costa E SilvaService of Nephrology, School of Medicine, University of Sao Paulo, Av. Doutor Arnaldo 251, Sao Paulo, SP, CEP: 01246-000, Brazil.
Gillene S FerreiraService of Nephrology, School of Medicine, University of Sao Paulo, Av. Doutor Arnaldo 251, Sao Paulo, SP, CEP: 01246-000, Brazil.
Emmanuel A BurdmannService of Nephrology, School of Medicine, University of Sao Paulo, Av. Doutor Arnaldo 251, Sao Paulo, SP, CEP: 01246-000, Brazil.
Luis YuService of Nephrology, School of Medicine, University of Sao Paulo, Av. Doutor Arnaldo 251, Sao Paulo, SP, CEP: 01246-000, Brazil.
Etienne MacedoService of Nephrology, School of Medicine, University of Sao Paulo, Av. Doutor Arnaldo 251, Sao Paulo, SP, CEP: 01246-000, Brazil.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSingle-pass batch dialysis (SBD) is a well-established system for treatment of end-stage renal disease. However, little evidence is available on sustained low-efficiency extended dialysis (SLED) performed with SBD in patients with acute kidney injury (AKI) in the intensive care unit (ICU).

methodsAll SLED-SBD sessions conducted on AKI patients in nine ICUs between March and June 2010 were retrospectively analyzed regarding the achieved metabolic and fluid control. Logistic regression was performed to identify the risk factors associated with hypotension and clotting during the sessions.

resultsData from 106 patients and 421 sessions were analyzed. Patients were 54.2 ± 17.0 years old, 51 % males, and the main AKI cause was sepsis (68 %); 80 % of patients needed mechanical ventilation and 55 % vasoactive drugs. Hospital mortality was 62 %. The median session time was 360 min [interquartile range (IQR) 300-360] and prescribed ultrafiltration was 1500 ml (IQR 800-2000). In 272 sessions (65 %) no complications were recorded. No heparin was used in 269/421 procedures (64 %) and system clotting occurred in 63 sessions (15 %). Risk factors for clotting were sepsis [odds ratio (OR) 2.32 (1.31-4.11), p = 0.004], no anticoagulation [OR 2.94 (1.47-5.91), p = 0.002] and the prescribed time (hours) [OR 1.14 (1.05-1.24), p = 0.001]. Hypotension occurred in 25 % of procedures and no independent risk factors were identified by logistic regression. Adequate metabolic and fluid balance was achieved during SLED sessions. Median blood urea decreased from 107 to 63 mg/dl (p < 0.001), potassium from 4.1 to 3.9 mEq/l (p < 0.001), and increased bicarbonate (from 21.4 to 23.5 mEq/l, p < 0.001). Median fluid balance during session days ranged from +1300 to -20 ml/24 h (p < 0.001).

conclusionsSLED-SBD was associated with a low incidence of clotting despite frequent use of saline flush, and achieved a satisfactory hemodynamic stability and reasonable metabolic and fluid control in critically-ill AKI patients.

Indexed as

Critical IllnessAcute Kidney InjuryAdultAgedFemaleHumansIntensive Care UnitsMaleMiddle AgedRenal DialysisRetrospective StudiesAcute kidney injuryCritically-ill patientsHemodialysisIntensive care unitSingle pass batch systemSlow extended hemodialysis

Identifiers

PMID26298845

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Registered trials

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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.