Evidence map›Paper›PMID 39471783›Full record

Observational studyBlood purification2025

Reduction Rate of Uric Acid in Blood during Continuous Renal Replacement Therapy for Acute Kidney Injury: A Multicenter Retrospective Observational Study.

Yutaro Inoue, Ryota Inokuchi, Hidehiko Nakano, Yoshiki Masuda, Osamu Nishida, Kent Doi, CHANGE Study Group

Abstract readObservational StudyMulticenter Study
In one paragraph

Observational study in Blood purification, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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.

Yutaro InoueDepartment of Emergency and Critical Care Medicine, The University of Tokyo, Tokyo, Japan.
Ryota InokuchiDepartment of Emergency and Critical Care Medicine, The University of Tokyo, Tokyo, Japan.
Hidehiko NakanoDepartment of Emergency and Critical Care Medicine, The University of Tokyo, Tokyo, Japan.
Yoshiki MasudaDepartment of Intensive Care Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan.
Osamu NishidaDepartment of Anesthesiology and Critical Care Medicine, School of Medicine, Fujita Health University, Toyoake, Japan.
Kent DoiDepartment of Emergency and Critical Care Medicine, The University of Tokyo, Tokyo, Japan.
CHANGE Study Group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionContinuous renal replacement therapy (CRRT) eliminates these small solutes with equal efficacy under the same conditions. However, variations in the reduction rates of these solutes observed in patients with CRRT are likely influenced by factors other than removal through CRRT. This study evaluated the reduction rates of these small solutes during CRRT and their possible association with mortality.

methodsThis study used the data of limited patients registered in the CHANGE study, which is a large retrospective observational study on CRRT management across 18 Japanese ICUs. Reduction rates of three solutes in blood, calculated on the 1st and 2nd days, were compared in patients with acute kidney injury (AKI) treated by CRRT. The potential association between solute reduction rates and mortality during CRRT or within 7 days after the termination of CRRT was evaluated.

resultsIn total, 163 patients with AKI were included in the analysis. The reduction rates of uric acid (UA) were significantly higher than those of urea and creatinine for the 1st and 2nd tests in the entire cohort. Receiver operating characteristic (ROC) curve analysis revealed that lower UA reduction rates were significantly associated with mortality during CRRT or within 7 days after CRRT termination {area under the ROC curve: 0.62 [95% confidence interval (CI): 0.52-0.71] for the 1st test and 0.63 [95% CI: 0.54-0.72] for the 2nd test}. After adjusting for age and SOFA score, a significant association was observed between lower UA reduction rates and hospital mortality for both tests.

conclusionAmong the small solutes, UA reduction rates in patients with AKI treated with CRRT were notably higher than those of creatinine and urea. Furthermore, the significant association between lower UA reduction rates and mortality suggests that UA reduction rate may serve as a valuable indicator of insufficient removal of uremic solutes by CRRT, although the decline in UA production must be taken into account.

introductionContinuous renal replacement therapy (CRRT) eliminates these small solutes with equal efficacy under the same conditions. However, variations in the reduction rates of these solutes observed in patients with CRRT are likely influenced by factors other than removal through CRRT. This study evaluated the reduction rates of these small solutes during CRRT and their possible association with mortality.

methodsThis study used the data of limited patients registered in the CHANGE study, which is a large retrospective observational study on CRRT management across 18 Japanese ICUs. Reduction rates of three solutes in blood, calculated on the 1st and 2nd days, were compared in patients with acute kidney injury (AKI) treated by CRRT. The potential association between solute reduction rates and mortality during CRRT or within 7 days after the termination of CRRT was evaluated.

resultsIn total, 163 patients with AKI were included in the analysis. The reduction rates of uric acid (UA) were significantly higher than those of urea and creatinine for the 1st and 2nd tests in the entire cohort. Receiver operating characteristic (ROC) curve analysis revealed that lower UA reduction rates were significantly associated with mortality during CRRT or within 7 days after CRRT termination {area under the ROC curve: 0.62 [95% confidence interval (CI): 0.52-0.71] for the 1st test and 0.63 [95% CI: 0.54-0.72] for the 2nd test}. After adjusting for age and SOFA score, a significant association was observed between lower UA reduction rates and hospital mortality for both tests.

conclusionAmong the small solutes, UA reduction rates in patients with AKI treated with CRRT were notably higher than those of creatinine and urea. Furthermore, the significant association between lower UA reduction rates and mortality suggests that UA reduction rate may serve as a valuable indicator of insufficient removal of uremic solutes by CRRT, although the decline in UA production must be taken into account.

Indexed as

Acute Kidney InjuryContinuous Renal Replacement TherapyUric AcidAgedAged, 80 and overCreatinineFemaleHumansMaleMiddle AgedRetrospective StudiesCreatinineUric AcidAcute kidney injuryContinuous renal replacement therapyRemovalSmall soluteUric acid

Identifiers

PMID39471783
PMCPMC11854975

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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.