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Kidney Week

Abstract: SA-PO158

Dyschloremia and Prognosis in Patients with AKI Requiring Continuous Renal Replacement Therapy

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical, Outcomes, and Trials

Author

  • Shin, Dong Ho, College of Medicine, Hallym University, Seoul, Korea (the Republic of)
Background

Dyschloremia is common in critically ill patients. There has been some interest in the low or high serum chloride levels as poor prognostic factor of them. However, litter is known about the impact of dyschloremia in patients with acute kidney injury (AKI) requiring continuous renal replacement therapy (CRRT).

Methods

A total of 980 patients who received CRRT for AKI between 2009 and 2018 were collected and divided into 3 groups according to the serum chloride levels at the timing of CRRT. Thirty-day all-cause mortality and continued dialysis dependence after hospital discharge was compared among groups.

Results

The hypochloremia group (serum chloride < 98mEq/L, n = 190), normochloremia group (98 ≤ serum chloride ≤ 110 mEq/L, n = 647), and hyperchloremia groups (serum chloride > 110 mEq/L, n = 143) were divided based on the reference values of serum chloride. Compared to normochloremia group, simplified acute physiology III score were higher in hyperchloremia and hypochloremia group. On multivariate logistic regression, hypochloremia group (odd ratio, 1.38; 95% confidence interval, 1.12 - 1.69; p = 0.02) and hyperchloremia group (odd ratio, 1.57; 95% confidence interval, 1.32 - 2.54; p = 0.04) were significantly associated with mortality. In continued dialysis dependence after hospital discharge, similar trends were observed. Moreover, Kaplan-Meier analysis revealed that mortality was significantly higher in hypochloremia and hyperchloremia groups than normochloremia group.

Conclusion

This study showed that dyschloremia was a predictor for poor prognosis in patients with acute kidney injury requiring CRRT.