Evidence map›Paper›PMID 41843064›Full record

Observational studyIntensive care medicine2026

Predictive factors of successful renal replacement therapy weaning : Deciding On patients Orientations after Renal replacement therapy Stopping (The DOORS study).

Khalil Chaïbi, Yanis Akrour, Guillaume Louis, Laurent Martin Lefevre, Bertrand Pons, Sébastien Moschietto, Eric Boulet, David Hajage, Saïd Lebbah, Jean-Pierre Quenot and 5 more

Abstract readObservational Study
In one paragraph

Observational study in Intensive care medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing 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

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. 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

15 authors.

Khalil Chaïbi *Département de réanimation médico-chirurgicale, APHP Hôpital Avicenne, Bobigny, France. khalil.chaibi@aphp.fr.ORCID 0000-0001-9106-586X
Yanis Akrour *Département de réanimation médico-chirurgicale, APHP Hôpital Avicenne, Bobigny, France.
Guillaume LouisRéanimation polyvalente, CHR Metz-Thionville Hôpital de Mercy, Metz, France.
Laurent Martin LefevreRéanimation polyvalente, CHR départementale La Roche sur Yon, La Roche sur Yon, France.
Bertrand PonsRéanimation, CHU Pointe-a-Pitre/Abymes, Pointe-a-Pitre, France.
Sébastien MoschiettoRéanimation polyvalente, CHG d'Avignon Henri Duffaut, Avignon, France.
Eric BouletRéanimation polyvalente, CH René Dubos, Pontoise, France.
David HajageSorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Département de Santé Publique, Centre de Pharmacoépidémiologie, Paris, France.
Saïd LebbahSorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Département de Santé Publique, Centre de Pharmacoépidémiologie, Paris, France.
Jean-Pierre QuenotDepartment of Intensive Care, François Mitterrand University Hospital, Dijon, France.
Frederic SanglaDepartment of Cell Physiology and Metabolism, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
Didier DreyfussCommon and Rare Kidney Diseases, Sorbonne Université, INSERM, UMR-S 1155, Paris, France.
Stéphane Gaudry *Département de réanimation médico-chirurgicale, APHP Hôpital Avicenne, Bobigny, France.
David Legouis *Department of Cell Physiology and Metabolism, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
DOORS investigators

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionRenal replacement therapy (RRT) is a life-saving intervention in severe acute kidney injury (AKI). After a clinician-initiated discontinuation, the likelihood of sustained liberation remains uncertain. We aimed to identify predictors of successful RRT weaning and to develop a pragmatic bedside tool (the UNDERSCORE) to support post-discontinuation management.

methodsThis post-hoc analysis of two multicenter randomized trials (AKIKI and AKIKI2) included ICU patients with KDIGO stage 3 AKI managed with a conservative initiation approach. Patients were eligible if they underwent an RRT weaning attempt, defined as discontinuation for ≥ 3 consecutive days. The primary outcome was successful weaning, i.e., no RRT resumption within seven days. Independent predictors were identified using multivariable logistic regression, and the resulting model (UNDERSCORE) was externally validated in an independent Swiss ICU cohort.

resultsAmong 554 patients who received RRT, 180 underwent a weaning attempt and 101 (56%) were successfully weaned. Six predictors were retained to construct the UNDERSCORE: RRT duration before the attempt, septic shock on admission, baseline serum creatinine, and three clinical variables assessed after the weaning attempt (use of vasopressors, invasive mechanical ventilation, and urine output). The score showed strong discrimination in the derivation cohort (AUC 0.86, 95% CI 0.80-0.91). In the external Swiss cohort (n = 415), 338 patients (81%) were successfully weaned, with fair performance across a broader case mix (AUC 0.73, 95% CI 0.66-0.80).

conclusionThe UNDERSCORE, derived from a homogeneous conservative RRT initiation cohort and validated in a diverse ICU population, provides a bedside tool to estimate the probability of sustained RRT discontinuation after an initial clinician-initiated stop.

Indexed as

Acute Kidney InjuryRenal Replacement TherapyAgedFemaleHumansIntensive Care UnitsLogistic ModelsMaleMiddle AgedMulticenter Studies as TopicRandomized Controlled Trials as TopicSwitzerlandAcute kidney injuryRenal replacement therapyWeaning score

Identifiers

PMID41843064
PMCPMC13035642

What OpenQuestion holds

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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.