Controlled study of decision-making algorithms for kidney replacement therapy initiation in acute kidney injury
Clinical Journal of the American Society of Nephrology Dec 22, 2021
Kelly Y, Mistry K, Ahmed S, et al. - Findings revealed that use of AKI (acute kidney injury)-Standardized Clinical Assessment and Management Plan (SCAMP) for AKI-KRT (AKI requiring kidney replacement therapy) was not significantly related to inpatient mortality but was found to be linked with decreased ICU and hospital length of stay and use of KRT in cases of physician-perceived treatment futility.
A 12-month controlled study was performed in the ICUs of a large academic tertiary medical center, and use of the AKI-SCAMP was alternated with use of a "sham" control form in 4-6-week blocks.
A total of 122 patients were in the AKI-SCAMP group and 102 patients were in the control group.
Experts found no significant difference in inpatient mortality linked with AKI-SCAMP use (41% vs 47% control).
Significantly decreased ICU length of stay (mean 8 (95% CI 8-9) vs 12 (95% CI 10-13) days) and hospital length of stay (mean 25 (95% CI 22-29) vs 30 (95% CI 27-34) days) were reported in relation to AKI-SCAMP use.
There were less chances of receiving KRT, in the context of physician-perceived treatment futility, among patients in the AKI-SCAMP group vs controls (2% vs 7%).
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