RESUMO

PURPOSE: The aim of this study is to evaluate the relationship between timing of renal replacement therapy (RRT) in severe acute kidney injury and clinical outcomes. METHODS: This was a prospective multicenter observational study conducted at 54 intensive care units (ICUs) in 23 countries enrolling 1238 patients. RESULTS: Timing of RRT was stratified into "early" and "late" by median urea and creatinine at the time RRT was started. Timing was also categorized temporally from ICU admission into early (<2 days), delayed (2-5 days), and late (>5 days). Renal replacement therapy timing by serum urea showed no significant difference in crude (63.4% for urea 24.2 mmol/L; odds ratio [OR], 0.92; 95% confidence interval [CI], 0.73-1.15; P = .48) or covariate-adjusted mortality (OR, 1.25; 95% CI, 0.91-1.70; P = .16). When stratified by creatinine, late RRT was associated with lower crude (53.4% for creatinine >309 micromol/L vs 71.4% for creatinine

Assuntos

Injúria Renal Aguda/terapia , Cuidados Críticos/métodos , Estado Terminal/terapia , Seleção de Pacientes , Terapia de Substituição Renal/métodos , Injúria Renal Aguda/sangue , Injúria Renal Aguda/diagnóstico , Injúria Renal Aguda/mortalidade , Austrália/epidemiologia , Nitrogênio da Ureia Sanguínea , Brasil/epidemiologia , Causalidade , China/epidemiologia , Creatinina/sangue , Estado Terminal/mortalidade , Europa (Continente) , Feminino , Mortalidade Hospitalar , Humanos , Japão/epidemiologia , Tempo de Internação/estatística & dados numéricos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , América do Norte/epidemiologia , Estudos Prospectivos , Fatores de Tempo , Resultado do Tratamento