Impact of renal replacement therapy strategy on beta-lactam plasma concentrations: the BETAKIKI study—an ancillary study of a randomized controlled trial
Authors' conclusion
In this secondary analysis of a randomized controlled trial, renal replacement therapy initiation strategy did not significantly influence plasma trough concentrations of beta-lactams in ICU patients with severe AKI.
Study context
- Population
- Critically ill patients with severe acute kidney injury (AKI) (KDIGO 3) receiving beta-lactams620 in parent RCT
- Participants
- 112 patients
- Comparison
- Early vs delayed renal replacement therapy (RRT) initiation strategy
- Earlyn = 53
- Delayedn = 59reference
- Primary endpoint
- Proportion of patients with sufficient beta-lactam trough plasma concentration (>4 times the MIC)
Methodological detailsancillary study
- Ancillary study
Primary result
As reported in the abstract
P = 0.78
- Trough concentration >4 times minimal inhibitory concentration (MIC), whole population
- 80.4% (n = 90)
Further findings
Factors associated with adequate trough concentration (multivariate analysis)
| OR (CI) | P value | ||
|---|---|---|---|
| Septic shock | 3.95 (1.14–13.64) | P = 0.029 | |
| Higher MAP | 1.05 (1.01–1.10) | P = 0.013 | |
| 0.050.21520Odds ratio (log scale) |
Procalcitonin evolution, catecholamine-free days, mortality by trough concentration >4 times MIC or not
- Did not differ
Original publication
Impact of renal replacement therapy strategy on beta-lactam plasma concentrations: the BETAKIKI study—an ancillary study of a randomized controlled trial. Ann Intensive Care. Published 25 February 2023. doi:10.
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