Indian Journal of Critical Care Medicine· 2026Q2
PRACtices of Renal Replacement Therapy in Critically Ill Patients with Acute Kidney Injury (PRACRRT): A Prospective, Multicenter, Observational Cohort Study from Indian Intensive Care Units – An Indian Society of Critical Care Medicine ResearchNet Study
- 1citations
- Q2SCImago
- 2026year
Short summary
In Indian ICUs, sustained low-efficiency dialysis (SLED) was the most common RRT modality (50.1%) for 585 critically ill AKI patients, with a 38.8% hospital mortality rate and only 22.6% complete renal recovery at 90 days.
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Key points
- Sustained low-efficiency dialysis (SLED) was the most frequent RRT modality (50.1%) in 27 Indian ICUs.
- Hospital mortality for critically ill AKI patients undergoing RRT was 38.8%.
- Only 22.6% of patients achieved complete renal recovery at 90 days.
- Vasopressor use, ventilatory support, and emergency RRT were associated with increased mortality.
- Organ dysfunction, RRT interruption, and vasopressor use predicted renal non-recovery.
AI-generated from the title and abstract; the full text is not read.
Abstract
Background and aim: Acute kidney injury (AKI) requiring renal replacement therapy (RRT) in critically ill patients is associated with substantial mortality and renal sequelae.Since data on RRT practices from Indian intensive care units (ICUs) remain sparse, we conducted a study to evaluate RRT practices and their association with mortality and long-term renal outcomes. Patients and Methods:We conducted a prospective, multicenter observational cohort study across 27 ICUs in India.Data on institutional infrastructure, patient characteristics, and RRT practices were collected.Primary outcomes were all-cause hospital mortality and renal recovery at 90 days.Results: A total of 585 patients underwent 1,520 RRT sessions.The majority were treated in private hospital ICUs (77.8%).Sustained low-efficiency dialysis (SLED) was the most frequently used modality (50.1%).Hospital mortality was 38.8%.Predictors of mortality included vasopressors [odds ratio (OR) = 2.743, 95% confidence interval (CI) = 2.091-3.597],ventilatory support (OR = 1.674, 95% CI = 1.284-2.183),RRT on day of ICU admission (OR = 1.062, 95% CI = 1.005-1.123),emergency RRT (OR = 2.801, 95% CI = 1.007-7.793),delayed RRT initiation (OR = 1.393, 95% CI = 1.014-1.913),and complications during RRT (OR = 1.748, 95% CI = 1.219-2.506).At 90 days, complete renal recovery occurred in 22.6%, 28.3% showed partial recovery, while 36.0%showed non-recovery, with 15.9% being RRT dependent.Predictors of renal non-recovery included organ dysfunction (OR = 1.382, 95% CI = 1.062-1.800),vasopressors (OR = 1.804, 95% CI = 1.392-2.337),lactate (OR = 1.798, 95% CI = 1.428-2.263),ultrasound-guided catheterization (OR = 1.718, 95% CI = 1.360-2.170),RRT interruption (OR = 7.620, 95% CI = 2.429-23.906),age (OR = 1.434, 95% CI 1.066-1.929),and large cannulas.Conclusion: Renal replacement therapy practices in Indian ICUs are characterized by predominant use of SLED.Wide variation in RRT practices and low long-term renal recovery highlight the need for structured RRT protocols and continued post-discharge renal care.
The authors' abstract, as published at the source. Indian Journal of Critical Care Medicine, 2026 · DOI ↗
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Field: Nephrology
NephrologyMedicine