Abstract: SA-PO088

Risk Factors Associated with Early Mortality in Continuous Renal Replacement Therapy for AKI

Session Information

Category: Acute Kidney Injury

  • 003 AKI: Clinical and Translational

Authors

  • Lee, Haewon, Haeundae Paik Hospital, inje university, Pusan, Korea (the Republic of)
  • Kim, Yang Wook, Haeundae Paik Hospital, inje university, Pusan, Korea (the Republic of)
  • Park, Bongsoo, Haeundae Paik Hospital, inje university, Pusan, Korea (the Republic of)
  • Park, Sihyung, Haeundae Paik Hospital, inje university, Pusan, Korea (the Republic of)
  • Park, Seok ju, Inje University, Busan, Korea (the Republic of)
  • Lee, Yoo jin, Haeundae Paik Hospital, inje university, Pusan, Korea (the Republic of)
Background

Continuous renal replacement therapy (CRRT) is a modality favored in hemodynamically unstable acute kidney injury (AKI) patients. However, the mortality of AKI is high despite the use of CRRT in intensive care units. In this study, we aimed to identify factors associated with an increased risk for 72-hour mortality in CRRT.

Methods

We conducted a retrospective observational study among 154 patients who received CRRT from March 2010 to December 2016. Laboratory parameters, demographic characteristics, administration of vasopressors, ventilator use, comorbidities, presence of anuria and fluid overload before starting CRRT were analyzed for any association with mortality.

Results

A total of 154 patients were enrolled in this study. Among them, 137 (89%) died in the ICU while on CRRT. Survivors and non-survivors showed significant differences in total bilirubin (1.61 ± 1.6 vs. 6.06 ± 7.73 mg/dl, p=0.01), mean BP (77.7 ±16.69 vs 66.91 ± 13.98 mmHg, p=0.01), systolic BP (108.53 ± 22.07 vs. 90.12 ± 19.63 mmHg, p=0.01), and amount of fluid overload for 3 days before initiating CRRT (5.02 ± 5.73 vs. 8.21 ± 5.44 L, p=0.01). Univariate analysis revealed parameters associated with mortality included ventilator use (OR 10.75, 95% CI 0.031~0.283), vasopressors (OR 4.16, 95% CI 0.085~1.71), malignancies (OR 4.76, 95% CI 0.04~0.9), and pre-CRRT fluid overload more than 2.5L (OR 3.91, 95% CI 1.06~14.3). Cox multivariate regression analysis was performed to exclude confounding factors. Use of vasopressors (HR 0.32, p=0.01), malignancy (HR 0.55, p=0.02), and pre-CRRT fluid overload (HR 0.63, p=0.03) were independent factors for death within 72 hours after initiating CRRT.

Conclusion

In conclusion, comorbidities such as malignancies, systolic blood pressure, and pre-CRRT fluid overload were closely related with 72-hour mortality in CRRT which may require close attention during ICU care. We emphasize the need to identify clinical or laboratory factors, especially those that are correctable, in the management of critical acute kidney injury.