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Please note that you are viewing an archived section from 2019 and some content may be unavailable. To unlock all content for 2019, please visit the archives.

Abstract: FR-PO038

Net Ultrafiltration Rate and Its Impact on Mortality in Patients with AKI Receiving CRRT

Session Information

  • AKI: Clinical Outcomes, Trials
    November 08, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Acute Kidney Injury

  • 102 AKI: Clinical, Outcomes, and Trials

Authors

  • Tehranian, Shahrzad, Mayo Clinic, Rochester, Minnesota, United States
  • Shawwa, Khaled, Mayo Clinic, Rochester, Minnesota, United States
  • Kashani, Kianoush, Mayo Clinic, Rochester, Minnesota, United States
Background

Fluid overload, a critical consequence of acute kidney injury (AKI), is associated with worse outcomes. The optimal volume of fluid removed per day during continuous renal replacement therapy (CRRT) is unknown. The purpose of this study is to evaluate the impact of ultrafiltration rate on mortality in critically ill patients with AKI receiving CRRT.

Methods

We retrospectively reviewed 1,398 patients with AKI who received CRRT between December 2006 and November 2015 at Mayo Clinic, Rochester, MN. The net ultrafiltration rate (UFNET) was categorized into low- and high-intensity groups (< 35 and ≥ 35 ml/kg/day, respectively). The impact of different UFNET intensities on 30-day mortality was assessed using logistic regression after adjusting for age, sex, body mass index, fluid balance from ICU admission to CRRT initiation, APACHE III and SOFA scores, baseline serum creatinine, ICU day at CRRT initiation, Charlson comorbidity index, and need for mechanical ventilation.

Results

The mean age was 62±15 years, 827 (59%) were male. There were 696 patients (49.8%) in low- and 702 (50.2%) in high-intensity groups. Thirty-day mortality was 755 (54%). There were 420 (60.4%) deaths in low-, and 335 (48%) in high-intensity group (p<0.001). UFNET ≥ 35 ml/kg/day remained independently associated with lower 30-day mortality (adjusted odds ratio (aOR): 0.49; 95% Cl: 0.39-0.63, p<0.001) compared to < 35 ml/kg/day.

Conclusion


More intensive fluid removal, UFNET ≥ 35 ml/kg/day among AKI patients receiving CRRT is associated with lower mortality. Future prospective studies are required to confirm such a finding.