Treatment of acute renal failure in Germany: a structural analysis

• Published in: Deutsche medizinische Wochenschrift (1946) Vol. 139; no. 34-35; p. 1701
• Main Authors: Schindler, R, Hutagalung, R, Jörres, A, John, S, Quintel, M I, Brunkhorst, F M, Heering, P
• Format: Journal Article
• Language: German
• Published: Germany 01.08.2014
• Subjects: Acute Kidney Injury - epidemiology; Acute Kidney Injury - therapy; Anesthesiology - organization & administration; Cooperative Behavior; Cross-Sectional Studies; Germany; Health Facility Size; Health Services Research; Humans; Intensive Care Units - organization & administration; Interdisciplinary Communication; Nephrology - organization & administration; Patient Care Team - organization & administration; Renal Replacement Therapy; Surveys and Questionnaires; Germany
• ISSN: 1439-4413
• DOI: 10.1055/s-0034-1370272

There are no reliable data on the structure and practice of the care of critically ill patients with acute renal failure in Germany. We carried out a detailed survey by sending a questionnaire to 2265 German Intensive Care Units. The questionnaire contained 19 questions regarding renal replacement therapy. 423 German intensive care units participated in the survey. Most of the ICUs are headed interdisciplinary (47%) or by anesthesiologists (30%), with significant differences depending on the size of the clinic, with primarily interdisciplinary management in smaller clinics. The offered type of renal replacement therapy varies significantly, the smaller the house the fewer methods are available. Thus, intermittent dialysis procedures are offered only in 35% of hospitals with up to 400 beds. The indication for the initiation of acute renal replacement therapy in intensive care is provided predominantly (53%) by an anesthesiologist. A nephrologist is only involved in 22% of all intensive care units. The indication is based primarily on a "clinical criteria", but these are poorly defined. Our results demonstrate the need for cross-disciplinary standards for the treatment of acute renal failure in German intensive care units.