Evaluating Real-World Data of CRRT Dose Prescription: Results from the CRRTnet Registry
Bibliographic record
Abstract
Background: While current guidelines recommend CRRT delivered dose of 20-25 ml/kg/h, practice variations on prescribed dose exist. This study aims to examine CRRT dose practice patterns and the relationship with clinical characteristics and outcomes. Methods: CRRTnet is a multicenter observational study of adults receiving CRRT. We included patients aged 18-89 years who underwent CRRT for >1 day and excluded those with ESRD. We utilized linear and logistic regression models to evaluate clinical characteristics associated with CRRT dose and clinical outcomes, respectively. Results: 931 patients corresponding to 6,166 CRRT patient-days were analyzed. The cohort consisted of 40% women and had a median age of 61 years, Charlson index of 2 (IQR: 1-4) and SOFA score at CRRT initiation of 15 (13-17). In-hospital mortality was 53.1% and among survivors 55.3% were HD dependent at discharge. Median CRRT initial prescribed dose was 31.1 (25.3-39.4) ml/kg/h with only 23.1% of patients initially prescribed guidelines-concordant CRRT dose. The median duration of CRRT was 4 (2-8) days and the median of the average prescribed CRRT dose throughout CRRT was 32.1 (25.9-40.7) ml/kg/h (Figure 1A). Clinical parameters independently associated with higher CRRT prescribed dose were lower BMI, CRRT indications of uremia and hyperkalemia, vasoactive drug use and %fluid overload at CRRT start (all p<0.01). Higher average prescribed CRRT dose was independently associated with increased in-hospital mortality (aOR 1.02 per 1 mL/kg/h, 95% CI 1.0-1.03, p=0.04) (Figure 1B). Average CRRT dose >30 (vs. ≤30) ml/kg/h had a borderline association with increased risk of in-hospital mortality (aOR 1.37, 0.99-1.90, p=0.06). Among survivors, average prescribed CRRT dose was not associated with HD dependence at discharge. Conclusion: In this registry, solute and volume CRRT indications as well as vasoactive drug exposure were independently associated with higher CRRT prescribed dose. Higher average prescribed CRRT dose was independently associated with increased risk of in-hospital mortality. Funding: NIDDK Support - NIDDK Support, NIDDK Support
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.008 | 0.026 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.005 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".