Page last updated on October 4, 2011 8:57 AM
PICS-SG - Renal Group
Acute Kidney Injury and Continuous replacement therapy are terms which are becoming more prevalent within our PICU's, and there is convincing evidence now that AKI in any PICU patient increases risk of mortality. The questions of how to diagnose AKI and when and how to intervene with CRRT are yet unanswered. What we do know about CRRT is largely based on data collected by the US prospective Paediatric CRRT Registry, which collected data from a number of US centres over a 5yr period (around 370 episodes RRT) and have published now 14 papers based on this data. This registry is currently not collecting data still but this will hopefully be rectified soon
I have recently reviewed PICANET data to look at numbers and outcomes of patients receiving CRRT in the last 5 years (2005-2010). This is work in progress still but we are looking at around 2600 episodes of CRRT (much more than in the US) and the preliminary data suggests our survival figures are better than those previously reported.
We are very keen to develop a UK registry of PCRRT and I think the preliminary data from PICANET suggests this would be worthwhile. However, with all data collection I am keen that we get the process right from the beginning and have therefore been talking with PICANET about adding a renal 'page' on to the PCCMCDS (which can't be until the PICANET web system goes fully live). This is now looking very possible and we are having a meeting of the PICS renal group later this month to discuss the data collection fields. (We are proposing a minimum dataset for PICANET and an optional more detailed dataset that participating centres can fill in voluntarily). If we get this right initially and embed it as part of the PICANET data collection it should have sustainability in terms of future long term data collection and review.
I have had an offer of financial support from Gambro (they also support the US registry and have offered to cover the cost that will be incurred from PICANET to set up the renal page) and I hope to get some support from Baxter/Edwards Life sciences as well.
With ideas of grandeur (!) it is my long term plan that if we get good data collection then we can start to guide practice and research in terms of timing and modality of CRRT ( as well as other aspects such as anticoagulation/lines/drug dosing etc).
We are having out next meeting on 18th October at 11am in the PICU Seminar Room at the Evelina, and if you would like to be involved, or know anyone within your units that would, please don't hesitate to come along or get in touch with me