Discrepancies between declared and real practices of continuous renal replacement therapy for septic acute kidney injury in French intensive care units
Authors' conclusion
This combined analysis highlights a discrepancy between reported weaning practices and observed bedside management at the centre level. Despite declared reliance on urine output, hemodynamic stability, and decongestion, CRRT is often discontinued under oliguria, residual vasopressor use, and persistent fluid overload.
Study context
- Population
- Intensivists and patients with septic acute kidney injury (AKI) weaned from continuous renal replacement therapy (CRRT) in French intensive care unit (ICUs)
- Participants
- 243 vs 116
- Exposure
- Declared vs real CRRT weaning practices
- Surveyn = 243
- Retrospectiven = 116
- Outcome
- Declared vs real CRRT weaning practices (urine output, vasopressors, fluid balance)
Methodological detailsnationwide survey
- Nationwide survey
Main finding
As reported in the abstract
CRRT weaning practices
| Group | Value | Urine output cited as main criterion | Daily reassessment | Protocol use | Urine output D-1, median | On norepinephrine at weaning | Norepinephrine median dose | Positive cumulative fluid balance | Median fluid balance | Diuretics prescribed |
|---|---|---|---|---|---|---|---|---|---|---|
| Survey | mean 612 (SD 328) mL/day | 93% | 74% | 3% | ||||||
| Retrospective | median 275 (range 30–967) mL | 122 mL [17-562] | 52% | 0.22 μg/kg/min | 72% | +5 L | 25% |
Value
Surveymean 612 (SD 328) mL/day
Retrospectivemedian 275 (range 30–967) mL
Urine output cited as main criterion
Survey93%
Retrospective— not stated in the abstract
Daily reassessment
Survey74%
Retrospective— not stated in the abstract
Protocol use
Survey3%
Retrospective— not stated in the abstract
Urine output D-1, median
Survey— not stated in the abstract
Retrospective122 mL [17-562]
On norepinephrine at weaning
Survey— not stated in the abstract
Retrospective52%
Norepinephrine median dose
Survey— not stated in the abstract
Retrospective0.22 μg/kg/min
Positive cumulative fluid balance
Survey— not stated in the abstract
Retrospective72%
Median fluid balance
Survey— not stated in the abstract
Retrospective+5 L
Diuretics prescribed
Survey— not stated in the abstract
Retrospective25%
Observational data: associations, not effects.
Further findings
Factors associated with weaning success/failure
- Successful weaning
- 63%
- Successful weaning: higher urine output at discontinuation and more frequent diuretic use (unadjusted); vasopressor support and fluid balance substantially overlapped
- Only persistent anuria as CRRT indication independently associated with weaning failure (multivariable)
Original publication
Discrepancies between declared and real practices of continuous renal replacement therapy for septic acute kidney injury in French intensive care units. Ann Intensive Care. Published 14 May 2026. doi:10.
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