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Kidney Week

Abstract: FR-PO090

The Significance of Initial Emergency Room Six-Hour Urine Volume for Survival in Critically Ill Patients Receiving Continuous Renal Replacement Therapy

Session Information

Category: Acute Kidney Injury

  • 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

  • Park, Kyungho, Chungnam National University Hospital, Daejeon, Korea (the Republic of)
  • Hwang, Yunkyeong, Chungnam National University Hospital, Daejeon, Korea (the Republic of)
  • Park, Heewon, Chungnam National University Hospital, Daejeon, Korea (the Republic of)
  • Han, Suyeon, Chungnam National University Hospital, Daejeon, Korea (the Republic of)
  • Park, Hye Rim, Department of Medical Science, Chungnam National University, Daejeon, Korea (the Republic of)
  • Lee, Eu Jin, Chungnam National University Hospital, Daejeon, Korea (the Republic of)
  • Kim, Hae Ri, Chungnam National University Sejong Hospital, Sejong, Korea (the Republic of)
  • Ham, Youngrok, Chungnam National University Hospital, Daejeon, Korea (the Republic of)
  • Na, Kiryang, Chungnam National University Hospital, Daejeon, Korea (the Republic of)
  • Lee, Kang Wook, Chungnam National University Hospital, Daejeon, Korea (the Republic of)
  • Choi, Dae Eun, Chungnam National University Hospital, Daejeon, Korea (the Republic of)
Background

The impact of initial emergency room(ER) factors on survival and renal function in critically ill patients receiving continuous renal replacement therapy(CRRT) has been poorly understood. This study aimed to investigate whether initial factors in ER have an influence on the survival and renal recovery of critically ill patients undergoing CRRT.

Methods

This retrospective single-center study included 332 critically ill patients who were admitted to intensive care units and received CRRT via the ER between March 1, 2018, and May 31, 2021. Various clinical parameters, such as urine output, estimated glomerular filtration rate (eGFR), and serum neutrophil gelatinase-associated lipocalin (NGAL), were assessed. The primary outcomes measured were the mortality rates at 30 days and 90 days, while the secondary outcomes focused on the duration of dialysis-free periods at 30 days and 90 days.

Results

The group with low urine output (LUO), defined as < 0.5 mL/kg/hr x 6 hours, displayed a significant association with both 30-day and 90-day mortality rates. The results of multivariable Cox regression analysis indicated that the LUO group had a significantly higher risk of 30-day mortality and 90-day mortality (hazard ratio, 1.935 and 2.141, respectively) compared to the high urine output (HUO) group, defined as ≥ 0.5 mL/kg/hr x 6 hours. There was no significant correlation between 30-day or 90-day mortality rates and initial eGFR or plasma NGAL levels. In critically ill patients undergoing CRRT, the HUO group and the group with initial eGFR ≥ 30 ml/min/1.73m2 were associated with a decreased 30-day and 90-day dialysis-free duration. However, serum NGAL levels did not show a significant association with 30-day and 90-day renal replacement therapy free duration.

Conclusion

The initial urine volume in ER emerges as a crucial factor for both 30-day and 90-day mortality rates in critically ill patients receiving CRRT.