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Kidney Week

Abstract: FR-PO026

Renal Outcomes and Recovery in a Large Cohort of Critically Ill Patients Requiring Venoarterial or Venovenous Extracorporeal Membrane Oxygenation and CRRT

Session Information

Category: Acute Kidney Injury

  • 101 AKI: Epidemiology, Risk Factors, and Prevention

Author

  • Hebert, Christopher, Kidney and Hypertension Associates of Dallas, Dallas, Texas, United States
Background

The development of acute kidney injury in adult patients requiring venoarterial or venovenous ECMO is very common. Many of these patients will require renal replacement therapy. Despite an extremely high mortality in such a patient population, centers are reporting improving outcomes with respect to survival. Little is known about the renal outcomes and renal recovery rate of those who required renal replacement therapy patients who survive to discharge.

Methods

Over the last 6 years, we have performed over 600 cannulations for VA or VV ECMO at our institution. Of these patients, 268 of them required renal replacement therapy for acute kidney injury. We have collected demographic and epidemiologic data as well as outcome data on those that have survived.

Results

Of the survivors, the cohort of patients most likely to recover renal function were patients with no prior known renal dysfunction who were on venovenous ECMO. The patients most likely to require ongoing hemodialysis at the time of discharge were patients with heart failure who were on venoarterial ECMO. Diabetes seemed to be a major risk factor in overall renal recovery, as did preadmission creatinine levels. Patients that recovered renal function after 30 days were typically those with no prior renal disease

Conclusion

Many of the traditional predictive measures for renal recovery after critical illness apply to the ECMO population. Despite having a large cohort of ECMO patients requiring renal replacement therapy, there is no clear pathway to being able to predict renal recovery.