The landscape of renal replacement therapy in Veterans Affairs Medical Center intensive care units

Figures & data

Figure 1. Map of types of renal replacement therapy used in veterans affairs intensive care units with intermittent hemodialysis capabilities. Accessed and edited from Wikimedia Commons with permission from the author.

Table 1. Renal replacement therapy by operational complexity.

Operational complexity
Standard	n = 1
IHD	1 (100.0)
Intermediate	n = 13
IHD only	6 (46.2)
CRRT	6 (46.2)
PIRRT	5 (38.5)
PIRRT alone	1 (7.7)
SLED alone	1 (7.7)
Complex	n = 62
IHD only	14 (22.6)
CRRT	36 (58.1)
PIRRT	23 (37.1)
PIRRT alone	12 (19.4)
SLED alone	11 (17.7)

Table 2. Variety of prolonged and continuous renal replacement therapy.

Type of prolonged or continuous renal replacement therapy (n = 55)	Respondents, n = 55 n (%)
CRRT (CVVH/CVVHD/CVVHDF)	42 (76.4)
CVVH	30 (54.5)
CVVHD	31 (56.4)
CVVHDF	26 (47.3)
PIRRT	28 (50.9)
SLED	23 (41.8)
Other	6 (10.9)
Exclusively PIRRT	13 (23.6)
Exclusively SLED	12 (21.8)

CRRT: continuous renal replacement therapy; CVVH: continuous veno-venous hemofiltration; CVVHD: continuous veno-venous hemodialysis; CVVHDF: continuous veno-venous hemodiafiltration; PIRRT: prolonged intermittent renal replacement therapy; SLED: slow low efficient dialysis.

Table 3. Access-related responses.

Access	n (%)
Anticoagulant locking (responses = 76/76; 100%)
Temporary catheter	55 (72.4)
Tunneled dialysis catheter	52 (68.4)
Locking content (responses = 76/76; 100%)
Citrate	9 (11.8)
Heparin	47 (61.8)
Saline	19 (25.0)
Alteplase	1 (1.3)
Catheter length (responses = 68/76; 89.5%)
12–13.5 cm	21 (30.9)
15–16 cm	42 (61.8)
19–20 cm	53 (77.9)
23–25 cm	31 (45.6)
>25 cm	7 (10.3)
Temporary triple-lumen dialysis catheter use during renal replacement therapy (responses = 76/76; 100%)	41 (54.0)
Arteriovenous fistula/graft use during CRRT/PIRRT (responses = 55/55; 100%)	15 (27.3)

Table 4. Staffing-related responses.

Providers of prolonged/continuous therapy (responses = 55/55)	n (%)
Intensivist	1 (1.8)
Nephrologist	52 (94.5)
Combined intensivist/nephrologist	2 (3.6)
Direct manager of CRRT (responses = 41/42; 95.2%)
ICU nurse	31 (77.5)
HD nurse	1 (2.4)
HD nurse set-up, ICU manage	9 (23.1)
Direct manager of PIRRT (responses = 28/28; 100.0%)
ICU nurse	3 (10.7)
HD nurse	17 (60.7)
HD nurse set-up, ICU manage	8 (28.6)
1:1 staffing (responses = 54/55; 98.2%)	34 (63.0)
1:1 for PIRRT only (responses = 8/13; 61.5%)	4 (50.0)
1:1 for CRRT only (responses = 26/27; 96.3%)	17 (65.4)

Figure 2. Anticoagulation on continuous renal replacement therapy.

Data availability statement

All relevant data are included in the paper.