Sensitivity www.selleckchem.com/products/PF-2341066.html analyses were performed to test whether any delay in RRT initiation could affect patients’ prognosis. For that purpose, the timing of RRT was divided into three classes (less than 24 h, between 24 and 48 h, greater than 48 h after reaching maximum RIFLE class).Since the use of the MDRD equation to estimate baseline creatinine values has not been validated in ICU patients, we also performed sensitivity analyses that included only patients with a normal serum creatinine value measured on ICU admission.Wald ��2 tests were used to determine the significance of each variable. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were calculated for each parameter estimate.Analyses were computed using the SAS 9.1 software package (SAS Institute, Cary, NC, USA).

ResultsStudy patientsOver the study period, 10,911 patients with a single ICU stay were screened, of whom 2,272 were excluded for the following reasons: decision to withhold or withdraw life-sustaining treatments (n = 1,378, 12.6%), history of chronic kidney disease (n = 672, 6.2%), functional renal failure (n = 176, 1.6%), and RRT for extra-renal indications (n = 46, 0.4%).Among the remaining 8,639 patients, 2,846 (32.9%) had AKI (1,025 (36%) R class patients, 830 (29.2%) I class patients, and 991 (34.8%) F class patients).RRT was initiated in 545 (19.1%) AKI patients (41 (7.5%) R class patients, 110 (20.2%) I class patients, and 394 (72.3%) F class patients).Patients who received RRT were younger, had higher severity scores, were more likely to be transferred from ward, and presented more comorbidities than patients who did not receive RRT (Table (Table1).

1). Differences between patients with and without RRT according to the maximum RIFLE class reached during the ICU stay are shown in Additional files 1, 2, and 3.Table 1Baseline characteristics of acute kidney injury (AKI) patients with and without renal replacement therapy (RRT).Dynamics of AKI and timing of renal replacement therapyAKI occurred early in the course of ICU stay. Three-quarters of the patients reached their maximum RIFLE within three days after ICU admission.When a decision of RRT was made, RRT was started less than 48 h after reaching maximum RIFLE class in 479/545 (87.9%) patients. Continuous veno-venous hemofiltration/hemodiafiltration and intermittent hemodialysis were used as initial RRT modality in 345 (63.

3%) patients and 200 (36.7%) patients, respectively.Details on timings of AKI and RRT for each RIFLE class are shown in Tables Tables22 and and33.Table 2Timing of acute kidney injury (AKI).Table 3Timing of renal replacement therapy initiation.Differences in parameters (measured on reaching maximum RIFLE class) likely to trigger Brefeldin_A RRT between patients who actually received RRT and those who did not are presented in Table Table4.4.