Work

Optimizing a Dose Prescription as the First Step of Green Continuous Kidney Replacement Therapy

Year: 2025

Type: article

Abstract: Rationale & Objective: Continuous kidney replacement therapy (CKRT) requires a large amount of fluid; however, it is often overused in clinical settings, leading to fluid waste. This study aimed to investigate the influence of dose optimization on fluid consumption and dialysis efficacy. Study Design: Single-center prospective study. Setting & Participants: All patients treated with CKRT at Pusan National University Hospital between May 1 and December 31, 2023. Quality Improvement Activities: The CKRT prescription dose was adjusted from the previous 35-25-30 mL/kg/h, targeting delivered doses between 20 and 25 mL/kg/h, as per the Kidney Disease: Improving Global Outcomes recommendations. Outcomes: The primary outcome was the change in total fluid consumption, and the secondary outcome was the differences in the pattern of biochemical parameter changes after 48 hours of CKRT before and after the study (serum urea nitrogen, creatinine, potassium, phosphate, and bicarbonate). Analytic Approach: General linear model for the primary outcome; repeated measures analysis of variance for the secondary outcome. Results: < 0.001). The degree of biochemical changes was not significantly different before and after the study. Limitations: The fluid-saving effect may be greater in countries with heavier patients. Conclusions: Efforts to optimize CKRT dosing allowed for a 12.7% reduction in fluid consumption (ie, 6.7 L/person/d), without any additional changes in treatment efficacy.

Source: Kidney Medicine

DOI: 10.1016/j.xkme.2025.101088

Authors: Harin Rhee, Taeil Kim, Kyung Sook Jung, Eun Young Ku

Institutions: Pusan National University Hospital, Pusan National University

Language: English

Topic: Acute Kidney Injury Research

Subfield: Nephrology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,590