115195
论文已发表
注册即可获取德孚的最新动态
IF 收录期刊
- 3.6 Breast Cancer (Dove Med Press)
- 4.3 Clin Epidemiol
- 2.6 Cancer Manag Res
- 3.2 Infect Drug Resist
- 4.1 Clin Interv Aging
- 6.1 Drug Des Dev Ther
- 4.1 Int J Chronic Obstr
- 8.7 Int J Nanomed
- 2.5 Int J Women's Health
- 3.2 Neuropsych Dis Treat
- 2.4 OncoTargets Ther
- 2.6 Patient Prefer Adher
- 2.6 Ther Clin Risk Manag
- 3.1 J Pain Res
- 3.5 Diabet Metab Synd Ob
- 4.5 Psychol Res Behav Ma
- 3.4 Nat Sci Sleep
- 2.4 Pharmgenomics Pers Med
- 2.6 Risk Manag Healthc Policy
- 4.6 J Inflamm Res
- 2.3 Int J Gen Med
- 3.9 J Hepatocell Carcinoma
- 3.3 J Asthma Allergy
- 2.5 Clin Cosmet Investig Dermatol
- 3.0 J Multidiscip Healthc
已发表论文
肾脏重症监护病房医护主导模式与传统血液透析护士主导模式在连续性肾脏替代治疗中的比较：一项回顾性观察研究
Authors Zhang T, Jiang G, Yan H, Wang J, Lan X, Bai J, Deng Y, Zhang N, Gao Q, Shen Y, Wang X, Wei R
Received 23 June 2025
Accepted for publication 5 December 2025
Published 10 January 2026 Volume 2026:22 545995
DOI https://doi.org/10.2147/TCRM.S545995
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Professor Garry Walsh
Ting Zhang,1,* Gaiying Jiang,1,* Huinan Yan,1 Juzi Wang,2 Xin Lan,1 Jianming Bai,1 Yonghong Deng,1 Nan Zhang,1 Qian Gao,1 Yanting Shen,1 Xueqing Wang,1 Ruxian Wei1
1Department of Nephrology, Shanxi Provincial People’s Hospital, Taiyuan, People’s Republic of China; 2Department of Nursing, Shanxi Provincial People’s Hospital, Taiyuan, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Ruxian Wei, Department of Nephrology, Shanxi Provincial People’s Hospital, No. 29 Shuangta Temple Street, Taiyuan, Shanxi, 030012, People’s Republic of China, Tel +86 13403407583, Email weiruxian_x@163.com Xueqing Wang, Department of Nephrology, Shanxi Provincial People’s Hospital, No. 29 Shuangta Temple Street, Taiyuan, Shanxi, 030012, People’s Republic of China, Tel +86 13403407583, Email wang_xueqing@21cn.com
Background: The optimal organisational model for delivering continuous renal replacement therapy (CRRT) to critically ill patients remains a subject of investigation.
Objective: This study compared the impact of a kidney intensive care unit (KICU) healthcare-led model with a traditional haemodialysis nurse-led model on key clinical process indicators and patient outcomes during CRRT.
Methods: In this retrospective observational study, patients requiring CRRT admitted to the KICU of a tertiary hospital between January 2022 and December 2023 were selected. Patients were divided into two groups based on the treatment leadership: the KICU group, where CRRT was led by intensive care unit supervising physicians and nurses certified in critical care blood purification techniques, and the control group, led by supervising physicians and haemodialysis nurses. Data were collected via the hospital information system and nursing records. After propensity score matching, 1180 patients were included in each group. Supplementary multivariable regression analyses were performed to provide adjusted effect estimates. Outcomes included treatment interruption rate, catheter-related infection rate, complication rate, actual delivered effluent dose, catheter insertion to treatment initiation time and patient satisfaction.
Results: The KICU group demonstrated a significantly lower overall complication rate (1.8% vs 3.7%, p = 0.004) and a higher rate of achieving the prescribed effluent dose (87.7% vs 81.2%, p < 0.001). Time to CRRT initiation was shorter in the KICU group (23.75 ± 2.43 vs 30.60 ± 6.36 minutes, p < 0.05). Patient satisfaction was also higher (p < 0.05). No significant differences were found in treatment interruption or catheter-related infections. The benefits of the KICU model on these key outcomes remained statistically significant in multivariable-adjusted analyses.
Conclusion: Continuous renal replacement therapy management by a dedicated KICU multidisciplinary team was associated with a lower complication rate, improved delivery of the prescribed dialysis dose, faster treatment initiation and higher patient satisfaction compared with a traditional model. These findings suggest that a structured, healthcare-led model can optimise the CRRT process for critically ill patients. Further multicentre studies are warranted to confirm these results.
Keywords: renal intensive care unit, healthcare-led, continuous renal replacement therapy, influence
1Department of Nephrology, Shanxi Provincial People’s Hospital, Taiyuan, People’s Republic of China; 2Department of Nursing, Shanxi Provincial People’s Hospital, Taiyuan, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Ruxian Wei, Department of Nephrology, Shanxi Provincial People’s Hospital, No. 29 Shuangta Temple Street, Taiyuan, Shanxi, 030012, People’s Republic of China, Tel +86 13403407583, Email weiruxian_x@163.com Xueqing Wang, Department of Nephrology, Shanxi Provincial People’s Hospital, No. 29 Shuangta Temple Street, Taiyuan, Shanxi, 030012, People’s Republic of China, Tel +86 13403407583, Email wang_xueqing@21cn.com
Background: The optimal organisational model for delivering continuous renal replacement therapy (CRRT) to critically ill patients remains a subject of investigation.
Objective: This study compared the impact of a kidney intensive care unit (KICU) healthcare-led model with a traditional haemodialysis nurse-led model on key clinical process indicators and patient outcomes during CRRT.
Methods: In this retrospective observational study, patients requiring CRRT admitted to the KICU of a tertiary hospital between January 2022 and December 2023 were selected. Patients were divided into two groups based on the treatment leadership: the KICU group, where CRRT was led by intensive care unit supervising physicians and nurses certified in critical care blood purification techniques, and the control group, led by supervising physicians and haemodialysis nurses. Data were collected via the hospital information system and nursing records. After propensity score matching, 1180 patients were included in each group. Supplementary multivariable regression analyses were performed to provide adjusted effect estimates. Outcomes included treatment interruption rate, catheter-related infection rate, complication rate, actual delivered effluent dose, catheter insertion to treatment initiation time and patient satisfaction.
Results: The KICU group demonstrated a significantly lower overall complication rate (1.8% vs 3.7%, p = 0.004) and a higher rate of achieving the prescribed effluent dose (87.7% vs 81.2%, p < 0.001). Time to CRRT initiation was shorter in the KICU group (23.75 ± 2.43 vs 30.60 ± 6.36 minutes, p < 0.05). Patient satisfaction was also higher (p < 0.05). No significant differences were found in treatment interruption or catheter-related infections. The benefits of the KICU model on these key outcomes remained statistically significant in multivariable-adjusted analyses.
Conclusion: Continuous renal replacement therapy management by a dedicated KICU multidisciplinary team was associated with a lower complication rate, improved delivery of the prescribed dialysis dose, faster treatment initiation and higher patient satisfaction compared with a traditional model. These findings suggest that a structured, healthcare-led model can optimise the CRRT process for critically ill patients. Further multicentre studies are warranted to confirm these results.
Keywords: renal intensive care unit, healthcare-led, continuous renal replacement therapy, influence