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Abstract: SA-PO162

The Value of Body Composition Analysis in Predicting the Prognosis of Patients with AKI Undergoing Continuous Renal Replacement Therapy

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical, Outcomes, and Trials

Authors

  • Mao, Huijuan, First Affiliated Hospital of Nanjing Medical University, Nanjing, JIANGSU , China
  • Wu, Buyun, Nanjing medical University, Nanjing City, JIANGSU , China
Background

To investigate the value of nutritional and fluid status measured by bioelectrical impedance methods in predicting the prognosis of AKI patients undergoing continuous renal replacement therapy (CRRT).

Methods

Patients with severe AKI treated with CRRT in the first affiliated hospital of Nanjing medical university from Sep.2016 to Sep.2018 were prospectively enrolled, and divided into death group and survival group according to 28-day survival. Cox regression was used to analyze the association between 28-day survival and lean Tissue Index(LTI), fat Tissue Index(FTI), the ratio of extracellular water(ECW) and body cell mass (BCM) (ECW/BCM), and overhydration (OH),respectively.

Results

A total of 156 patients were included, including 101 males and 55 females. The average age was 62.7±15.4 years, with an average SOFA score of 9.9±3.9. The 28-day mortality rate was 46.2%. The pre-CRRT OH values and ECW/BCM values of the 28-day survival group and death group were 3.0(1.8, 5.5) L vs. 4.2(3.0, 5.7) L (P=0.016), 1.00(0.76, 1.18) vs. 1.07(0.88, 1.25) (P=0.033), respectively. Pre-CRRT high OH values (HR=0.83,95%CI=0.72-0.95,P=0.008) and high ECW/BCM values (HR=6.79,95%CI=1.72-26.82,P=0.006)were associated with 28-day death, while LTI and FTI were uncorrelated with 28-day death. The changes of OH values(HR=0.83,95%CI=0.72~0.95,P=0.008), ECW/BCM values(HR=6.79,95%CI=1.72~26.82,P=0.006) and FTI values(HR=1.12,95%CI=1.02~1.22,P=0.023) between pre-CRRT and the 7th day after CRRT initiation were significantly associated with 28-day mortality in patients survived 7 days after CRRT initiation. After adjusting for age, gender, and SOFA scores, the high OH value before CRRT, the changes of OH values , ECW/BCM values and FTI values between pre-CRRT and the 7th day after CRRT initiation, were independently associated with 28-day death.

Conclusion

In bioelectrical impedance analysis, the OH value and ECW/BCM value before CRRT is associated with 28-day mortality in patients with AKI, while the nutritional indicator LTI is not significantly related. The correction of fluid overload by CRRT within 7 days may reduce the 28-day risk of death.