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Kidney Week

Abstract: FR-PO053

Fluid Balance After Continuous Renal Replacement Therapy Initiation Is a Predictor of Mortality

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

  • An, Jung Nam, Seoul National University Boramae Medical Center, Seoul, Korea (the Republic of)
  • Oh, Hyung Jung, Ewah Womans University, Mokdong Hospital, Seoul, Korea (the Republic of)
  • Lee, Jung Pyo, Seoul National University Boramae Medical Center, Seoul, Korea (the Republic of)
  • Kim, Dong Ki, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Ryu, Dong-Ryeol, Ewha Womans University, Seoul, Korea (the Republic of)
  • Kim, Sejoong, Seoul National University Bundang Hospital, Seongnam, GyeonGgi-Do, Korea (the Republic of)
Background

Higher cumulative fluid balance in critically ill patients was associated with hospital mortality. Inbody, impedance body fat analyzer, can measure body water, and segmental water values. In this study, we examined the fluid balance by time using bioimpedance analysis (inbody), and investigated the association of fluid balance with clinical outcomes in the CRRT patients.

Methods

Among the patients who started CRRT at multi-center from May 2017 to March 2018, Inbody was measured at D0, D1, D2, and D7. Fluid overload was defined when either of the following two conditions is met; total body water (TBW)/height2 more than 13 L/m2 or the change of body weight more than 5%. Reaching euvolemia was defined when either of the following two conditions is met; at day 7, TBW/height2 was less than 13 L/m2 or the change during 7 days was less than -2.1 L/m2. The association with 60-days mortality was investigated.

Results

72% patients showed fluid overload. These patients were younger and had lower urine amount during 2 hours before CRRT, and started CRRT later compared to those without fluid overload. The change of body weight and TBW/height2 at CRRT initiation were much more than those without fluid overload. There is no statistical significance; however, the patients with fluid overload at CRRT initiation were shown to have a higher risk for mortality. Among the patients with fluid overload, 36 patients reached euvolemia at 7 days after CRRT initiation. Comparing with patients who failed to reach euvolemia, TBW/height2 at each time point and delta value during 7 days were significantly lower in the patients who reached euvolemia. Failing to reach euvolemia was a risk factor of 60-day mortality. After adjusted for age, gender, BMI, charlson comorbidity index, APACHE II, and SOFA score, failing to reach euvolemia were closely correlated with 60-day mortality, doubling the risk of mortality.

Conclusion

Fluid overload at CRRT initiation, defined based on the change of body weight and TBW/height2, was associated with the 60-day mortality. Based on the definition using TBW/height2 measured by InBody®, patients who failed to reach euvolemic status within 7 days after CRRT initiation showed a higher mortality rate, compared to those who reached euvolemic status.