Predictive factors of successful renal replacement therapy weaning : Deciding On patients Orientations after Renal replacement therapy Stopping (The DOORS study) - PubMed
7 hours ago
- #Renal replacement therapy
- #Acute kidney injury
- #Weaning score
- The DOORS study aimed to identify predictors of successful renal replacement therapy (RRT) weaning in ICU patients with severe acute kidney injury (AKI).
- A pragmatic bedside tool called UNDERSCORE was developed to support post-discontinuation management of RRT.
- The study included patients from two multicenter randomized trials (AKIKI and AKIKI2) who underwent RRT weaning attempts.
- Successful weaning was defined as no RRT resumption within seven days after discontinuation.
- Six predictors were identified for the UNDERSCORE tool: RRT duration before the attempt, septic shock on admission, baseline serum creatinine, and post-weaning clinical variables (vasopressors use, invasive mechanical ventilation, and urine output).
- The UNDERSCORE tool showed strong discrimination in the derivation cohort (AUC 0.86) and fair performance in an external Swiss ICU cohort (AUC 0.73).
- The study concluded that UNDERSCORE provides a reliable bedside tool to estimate the probability of sustained RRT discontinuation after an initial clinician-initiated stop.