Abstract: FR-PO052
The Interactive Effects of Input and Output on Managing Fluid Balance in Patients with AKI Requiring Continuous Renal Replacement Therapy
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
- Kong, Kyoung Hye, Ewha Womans University, Seoul, Korea (the Republic of)
- Oh, Hyung Jung, Ewah Womans' University, Mokdong Hospital, Seoul, Korea (the Republic of)
- Ryu, Dong-Ryeol, Ewha Womans University, Seoul, Korea (the Republic of)
Background
Fluid balance is a key factor for better survival rate in patients with acute kidney injury (AKI) requiring continuous renal replacement therapy (CRRT). However, appropriate regulation of input and output to achieve optimal fluid balance is not well elucidated yet. This study aimed to evaluate the effect of fluid components on mortality in patients with AKI requiring CRRT.
Methods
A total of 258 patients who were in the intensive care units of Ewha Womans University Hospital and with AKI required CRRT were enrolled (from 2016 to 2018). The amounts of fluid input and output were assessed by electronical medical charts with 24-hr and 72-hr intervals immediate after initiation of CRRT. The study endpoints were 7-, 14-, and 28-days all-cause mortality.
Results
The mean age of study subjects were 64.7 ± 15.8 years and 165 (64.0%) were male. The 28-day mortality was observed 118 (53.9%) cases during the follow-up. The amounts of cumulative fluid balance and cumulative input were higher and cumulative output was lower in non-survivors compared to survivors during 72-hr after CRRT initiation. A positive value of both 24-hr and 72-hr assessed cumulative fluid balance was associated with increased risk for 7-, 14-, and 28-days mortality. When the subjects were classified according to tertiles of total input or output, the increasing amount of cumulative fluid balance assessed with 24-hr and 72-hr was associated with the increased risk for mortality irrespective of tertiles of total input. However, increasing amount of cumulative fluid balance was not associated with the mortality risk according to tertiles of output.
Conclusion
The impact of CFB on mortality might be more dependent on cumulative output. The physicians need to decrease the CFB of CRRT patients as much as possible and consider increasing patient removal.
Funding
- Government Support - Non-U.S.