{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T07:01:41Z","timestamp":1790060501136,"version":"4.0.1"},"reference-count":23,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing in Critical Care"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Continuous renal replacement therapy (CRRT) is the preferred renal replacement therapy for critically ill patients with acute kidney injury; however, unplanned treatment discontinuation remains a major challenge that compromises treatment efficacy and patient outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To investigate the risk factors and temporal trends associated with unplanned CRRT discontinuation using descriptive time\u2010series analysis and to identify evidence\u2010based nursing interventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>This retrospective cohort study was conducted at a tertiary hospital in China between January and December 2025. Univariate analysis and binary logistic regression were used to identify factors independently associated with unplanned discontinuation. Descriptive time\u2010series analysis with 7\u2010day moving average smoothing was applied to evaluate temporal patterns throughout the study period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Unplanned discontinuation occurred in 77 of 3128 CRRT sessions (2.46%). After adjustment, anticoagulation regimen, treatment duration (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and net ultrafiltration rate (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.032) were identified as independent predictors of unplanned discontinuation. Compared with no anticoagulation, nafamostat mesylate was associated with lower odds of unplanned CRRT discontinuation (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.013), whereas sodium citrate was associated with higher odds (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.004), likely reflecting centre\u2010specific implementation factors related to low citrate utilization. Descriptive time\u2010series analysis showed temporal fluctuations in unplanned discontinuation rates, with an apparent peak in November. Elevated circuit pressure was the leading cause of unplanned discontinuation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Unplanned CRRT discontinuation was associated with anticoagulation regimen, treatment duration and ultrafiltration rate. Standardized anticoagulation protocols, staff training, safe ultrafiltration practices and enhanced circuit pressure surveillance may reduce unplanned discontinuation and improve patient outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Relevance to Clinical Practice<\/jats:title>\n                    <jats:p>These findings provide nurses with evidence\u2010based strategies, including locally informed monitoring protocols, standardized anticoagulation checklists and circuit pressure early warning indicators, to reduce unplanned CRRT discontinuation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nicc.70637","type":"journal-article","created":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T01:43:34Z","timestamp":1786585414000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Factors Influencing Unplanned Discontinuation of Continuous Renal Replacement Therapy: A Descriptive Time\u2010Series Analysis"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8366-814X","authenticated-orcid":false,"given":"Wanning","family":"Jia","sequence":"first","affiliation":[{"name":"Department of Nephrology (Blood Purification Center) China\u2010Japan Friendship Hospital  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongjiao","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Nephrology (Blood Purification Center) China\u2010Japan Friendship Hospital  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruihan","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Nephrology (Blood Purification Center) China\u2010Japan Friendship Hospital  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haifeng","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Nephrology (Blood Purification Center) China\u2010Japan Friendship Hospital  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9883-7612","authenticated-orcid":false,"given":"Haitao","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Nephrology (Blood Purification Center) China\u2010Japan Friendship Hospital  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingyi","family":"Bi","sequence":"additional","affiliation":[{"name":"Department of Nephrology (Blood Purification Center) China\u2010Japan Friendship Hospital  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,12]]},"reference":[{"issue":"1","key":"e_1_2_13_2_1","first-page":"1","article-title":"KDIGO Clinical Practice Guideline for Acute Kidney Injury","volume":"2","author":"Kidney Disease: Improving Global Outcomes (KDIGO) Acute Kidney Injury Work Group","year":"2012","journal-title":"Kidney International. Supplement"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1441-2772(23)01454-0"},{"issue":"6","key":"e_1_2_13_4_1","first-page":"103","article-title":"Best Evidence Summary of Process Management for Preventing Unplanned Discontinuation of Continuous Renal Replacement Therapy","volume":"41","author":"Zhang J.","year":"2024","journal-title":"Military Nursing"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/nicc.13179"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/nicc.13196"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-023-04519-1"},{"issue":"5","key":"e_1_2_13_8_1","first-page":"1015","article-title":"Regional Citrate Versus Heparin Anticoagulation for Continuous Renal Replacement Therapy in Critically Ill Patients: A Meta\u2010Analysis of Randomized Controlled Trials","volume":"26","author":"Li R.","year":"2022","journal-title":"Therapeutic Apheresis and Dialysis"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-023-04519-1"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.20223311S160d"},{"issue":"15","key":"e_1_2_13_11_1","first-page":"2368","article-title":"Research Status of Clinical Application of Nafamostat Mesylate","volume":"36","author":"Liu Z. Y.","year":"2020","journal-title":"Chinese Journal of Clinical Pharmacology"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2026.1713412"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000002392"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.acap.2013.08.002"},{"key":"e_1_2_13_15_1","first-page":"161","volume-title":"Standard Operating Procedures for Blood Purification (2021 Edition)","author":"Chen X. M.","year":"2021"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.01280214"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1159\/000452755"},{"key":"e_1_2_13_18_1","article-title":"Knowledge, Attitude and Practice of CRRT Unplanned Discontinuation Management Among ICU Nurses","volume":"24","author":"Zhou Y. Z.","year":"2025","journal-title":"BMC Nursing"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCC.0000000000000545"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0802639"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0902413"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/nicc.12991"},{"issue":"1","key":"e_1_2_13_23_1","first-page":"3","article-title":"Analysis of Factors Related to Unplanned Machine Removal in Intermittent Renal Replacement Therapy","volume":"19","author":"Li X. J.","year":"2020","journal-title":"Chinese Journal of Blood Purification"},{"issue":"16","key":"e_1_2_13_24_1","first-page":"2447","article-title":"Causes and Nursing of Unplanned Disconnection of CRRT","volume":"18","author":"Zhou Y. 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