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Abstract: TH-PO066

Hyperlactatemia Is a Predictor of Mortality in Patients Undergoing Continuous Renal Replacement Therapy for AKI

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical‚ Outcomes‚ and Trials

Authors

  • Kim, Seong Geun, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
  • Lee, Jinwoo, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
  • Kang, Min woo, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
  • Kim, Dong Ki, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
  • Oh, Kook-Hwan, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
  • Joo, Kwon Wook, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
  • Kim, Yon Su, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
  • Han, Seung Seok, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
Background

Hyperlactatemia occurs frequently in critically ill patients, and this pathologic condition leads to worse outcomes in several disease subsets. Herein, we addressed whether hyperlactatemia is associated with the risk of mortality in patients undergoing continuous renal replacement therapy (CRRT) due to AKI.

Methods

A total of 1,661 patients who underwent CRRT for severe AKI were retrospectively reviewed between 2010 and 2020. The patients were categorized according to their serum lactate levels, such as high (≥ 7.6 mmol/l), moderate (2.1–7.5 mmol/l) and low (≤2 mmol/l), at the time of CRRT initiation. The hazard ratios (HRs) for in-hospital mortality were calculated with adjustment of multiple variables. The increase in the area under the receiver operating characteristic curve (AUROC) for the mortality risk was evaluated after adding serum lactate levels to the Sequential Organ Failure Assessment (SOFA) and the Acute Physiology and Chronic Health Evaluation (APACHE) II score-based models.

Results

The moderate and high lactate groups had a higher risk of mortality than the low lactate group, with HRs of 1.64 (1.22–2.20) and 4.18 (2.99–5.85), respectively. The lactate-enhanced models had higher AUROCs than the models without lactates (0.764 vs. 0.702 for SOFA score; 0.737 vs. 0.678 for APACHE II score).

Conclusion

Hyperlactatemia is associated with mortality outcomes in patients undergoing CRRT for AKI. Serum lactate levels may need to be monitored in this patient subset.