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Enfermería Nefrológica

On-line version ISSN 2255-3517Print version ISSN 2254-2884


SUAREZ, María del Tránsito; RODAS, Lida; QUINTELA, Marta  and  MEJIA, Adriana Patricia. Patient safety assessment in the clinical practice of renal replacement therapy in intensive care units. Enferm Nefrol [online]. 2023, vol.26, n.1, pp.49-58.  Epub May 09, 2023. ISSN 2255-3517.


Patient safety in intensive care units with intermittent renal replacement therapy is influenced by different factors; including patient-related, human, and technical factors.


Identify risk factors and major incidences present in clinical practice affecting the patient safety on intermittent renal replacement therapy.

Material and Method:

Descriptive and retrospective study of 413 sessions of intermittent renal replacement therapy. Demographic and clinical data, clinical and technical complications, monitor controls, corrective measures, and nurse-related risk factors were obtained using a dialysis expert questionnaire.


Out of the 413 sessions, 52.1% were intermittent hemodialysis. Patients had a mean age of 65 years and 78.7% were male. 35.1% were admitted by septic shock. Incidences include error in modality assignment (33.2%), outdated protocols (30.5%) and vascular access dysfunction (15.7%). As clinical complications found 47.6% in intermittent hemodialysis and 41.2% had hypotension. Technical complications in 37.7% of sessions, with total or partial extracorporeal circuit coagulation (16.7%). As personnel related factors highlighted the lack of standardized training program (57.1%), personnel variability (81%), and not attending scheduled training (52.4%).


Patient safety with renal replacement therapy in intensive care units is a multifactorial process involving non-modifiable patient-related aspects, incidences during the procedure, and complications. Although no major adverse effects were produced in the patient's clinical evolution, risk factors are considered potential and some of them predictable, controllable, and avoidable.

Keywords : safety; intensive care unit; hemodialysis; risk factors.

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