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Abstract: TH-PO036

Assessment of Fluid and Nutritional Status Using Bioimpedance Methods in AKI Patients Treated with Continuous Renal Replacement Therapy

Session Information

Category: Acute Kidney Injury

  • 101 AKI: Epidemiology, Risk Factors, and Prevention

Author

  • Mao, Huijuan, First Affiliated Hospital of Nanjing Medical University, Nanjing, JIangSu, China
Background

Bioelectrical impedance analysis is an essential method for maintenance hemodialysis patients to assess nutritional and fluid status, however, there is still a lack of research on the value of bioelectrical impedance analysis in evaluating the prognosis of acute kidney injury (AKI) patients treated with continuous renal replacement therapy (CRRT).

Methods

Patients with severe AKI treated with CRRT in the first affiliated hospital of Nanjing medical university from 2014 to 2017 were prospectively enrolled. They were divided into death group and survival group according to 28-day survival. Logistic regression was used to analyze 28-day survival and Lean Tissue Index (LTI), Fat Tissue Index (FTI), the ratio of extracellular water(ECW) and body cell mass (BCM) (ECW/BCM), and overhydration (OH) were recorded.

Results

A total of 145 patients were included. The average age was 62.6±15.6 ys, average APACHE II score 21.7±6.5, SOFA score 9.4±3.6, and body mass index of 24.1±4.3 kg/m2. The pre-CRRT body composition analysis parameters were as followed:OH 3.9 ± 3.1L, LTI 12.4 ± 3.4kg/m2, FTI 10.3 ± 4.5kg/m2, ECW 18.0 ± 4.2L, BCM 18.6 ± 7.3L. The 28-day mortality rate was 44.8%.The pre-CRRT OH values and ECW/BCM values in survival group and death group were 3.4±3.2L, 4.6±3.0L and 1.0±0.4,1.1±0.4 (P<0.05), respectively. The changes of OH values and ECW/BCM values between CRRT 1st day and CRRT 7th day were 1.4±2.2L, 3.0±3.0L and 0.08±0.22,0.25±0.27 (P<0.05), respectively in two groups. Univariate and multivariate logistic regression analysis showed that pre-CRRT high OH values and high ECW/BCM values were associated with 28-day death, while LTI values and FTI values were not significant correlated with 28-day death; After CRRT initiation, the changes of OH values and ECW/BCM values between CRRT 7th-1st day were significantly associated with 28-day mortality.

Conclusion

The pre-CRRT fluid status(indicators of OH and ECW/BCM)were associated with 28-day mortality in patients with AKI, while the nutritional indicators LTI and FTI were not significantly related to short-term mortality. The correction of fluid overload by CRRT within 7 days may reduce the 28-day risk of death.

Funding

  • Government Support - Non-U.S.