ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005


The Latest on Twitter

Kidney Week

Abstract: FR-PO448

Examining Mortality in the Multinational Observational Study of Continuous Renal Replacement Therapy (CRRT) Practices

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis


  • Neyra, Javier A., University of Kentucky Medical Center, Lexington, Kentucky, United States
  • Secic, Michelle, Secic Statistical Consulting, Inc., Cleveland, Ohio, United States
  • Rewa, Oleksa G., University of Alberta, Edmonton, Alberta, Canada
  • House, Andrew A., LHSC University Hospital, London, Ontario, Canada
  • Monga, Divya, University of Mississippi Medical Center, Madison, Mississippi, United States
  • Juncos, Luis A., Central Arkansas Veterans Healthcare System, Little Rock, Arkansas, United States
  • Piazza, Robin, Watermark Research Partners, Inc, Indianapolis, Indiana, United States
  • Bagshaw, Sean M., University of Alberta, Edmonton, Alberta, Canada
  • Goldstein, Stuart, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States
  • Heung, Michael, University of Michigan, Ann Arbor, Michigan, United States

Risk-stratification of patients receiving CRRT to guide practice is direly needed. Utilizing data from a registry of critically ill adults receiving CRRT, we report mortality and kidney recovery rates and examine clinical parameters associated with mortality.


Multi-national observational registry study including critically ill adults (age ≥18 and ≤89 years) receiving CRRT. Patients who received CRRT for <48 h or other type of acute RRT before CRRT were excluded. Moderate and severe kidney disease at baseline were defined as baseline serum creatinine >265 µmol/L and ESKD/kidney transplant, respectively.


566 critically ill patients receiving CRRT were included. Mean (SD) age was 58.7 (14.3) yrs., 58.5% were male. Mean BMI was 31.1 (8.0) kg/m2. Median [range] Charlson and APACHE-II scores were 2.0 [0.0-18.0] and 29.0 [9.0-50.0], respectively and 106 (18.7%) patients had moderate/severe kidney disease at baseline. Median days from ICU admission to CRRT initiation was 1.0 [0.0-52.0] and 213 (37.6%) patients had fluid overload (FO%) ≥10% at CRRT initiation. Median SOFA at CRRT initiation was 15.0 [6.0-23.0]. Mean delivered CRRT dose was 33.1 (14.1) ml/kg/h and the median FO% per CRRT-day was 1.4% [0.3%-7.0%]. ICU mortality rate was 48.4%. In a multivariable Cox model, age (>60 vs ≤60), BMI (>29.7 vs ≤29.7), moderate/severe kidney disease at baseline, FO% per CRRT-day (>1.4% vs ≤1.4%), the absence of circuit anticoagulation, diagnosis of sepsis or acute-on-chronic liver failure, and serum bicarbonate at CRRT initiation (≤20 vs >20 mmol/L) independently associated with higher ICU mortality. Among 217 survivors without moderate/severe kidney disease at baseline, 142 (65.4%) recovered kidney function no longer needing RRT at hospital discharge.


Approximately one of two critically ill adults receiving CRRT died in the ICU. However, almost two-thirds of survivors recovered kidney function sufficiently enough to be independent of RRT. We identified clinical parameters independently associated with ICU mortality. This registry can help develop and validate risk-stratification tools in this susceptible population, and identify modifiable risk factors for evaluation in clinical trials.


  • Private Foundation Support