Abstract: FR-PO045
Mortality in Patients with Sepsis and Non-Sepsis AKI Requiring CRRT: A Retrospective Single-Center Experience
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
- Viswanathan, Sahityan, Medical City Fort Worth, Fort Worth, Texas, United States
- Reddy, Prashanth, Medical City Fort Worth, Fort Worth, Texas, United States
- Balamuthusamy, Saravanan, Tarrant Nephrology Associates, FortWorth, Texas, United States
- Ellappan, Manonmani, PPG Health/ TRI, Fortworth, Texas, United States
- Govindaraju, Aruna, PPG Health, Fort Worth, Texas, United States
Background
Short term and long term renal and survival outcomes of pts who undergo CRRT is highly variable in published literature. We have done a retrospective analysis on patients who have required CRRT at our institution over a 3 year period and have analyzed their survival outcomes based on their reason for initiation of CRRT.
Methods
Single center retrospective analysis on all patients who underwent CRRT between January 2015 and December 2017 were included for the analysis. Patients who expired within 12 hours after initiation of CRRT were excluded. All the patients underwent CRRT (CVVHDF) using the PrismaFlex machine.
Patients were grouped under sepsis (sepsis group) vs other etiologies (non-sepsis group) based on the reason for initiation of CRRT. Renal and overall survival outcomes were analyzed between the 2 groups across multiple variables including comorbidities. Comparisons were made using T-test and correlations on primary outcomes based on need for CRRT was done using Pearson’s test. Each variable was independently correlated with etiology of CRRT using logistic multiple regression analysis.
Results
Sepsis was the underlying etiology for initiating CRRT in 64% of pts. Cardiogenic shock was the most common cause for the rest. Patient groups were comparable across all variables analyzed. There was 51% mortality in the patients who needed CRRT in the study population. Mortality was 55% in patients in the sepsis group and 48% in non-sepsis group (p=0.4). Mean duration of CRRT in patients with sepsis who were alive at the end of 1 month was 7.1 (5.5) days and 3.2 (2.8) days in pts who were in non-sepsis group (p< 0.001).
Conclusion
Hemodynamically unstable patients who were initiated on CRRT irrespective of sepsis or non-sepsis etiology had a significantly high mortality at the end of 30 days. Patients initiated on CRRT due to sepsis required CRRT 3.9 days more than patients in the non-sepsis group. However randomized clinical trials are needed to compare the need and efficacy of CRRT on renal and survival outcomes in patients requiring continuous slow dialysis.
Mean duration of CRRT
| Mean duration of CRRT (days) | Sepsis (n=83) | Non-sepsis (n=46) |
| Dead | 3.4 (3.1) | 4(2.9) |
| Alive | 7.1(5.5) | 3.2(2.8) |