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Abstract: TH-PO283

Clinical Factors Affecting Continuous Renal Replacement Therapy Circuit Survival

Session Information

Category: Dialysis

  • 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Choi, Soo yeon, Wonju Severance Christian Hospital, Wonju, Gangwon-do, Korea (the Republic of)
  • Shin, Donghui, Wonju Severance Christian Hospital, Wonju, Gangwon-do, Korea (the Republic of)
  • Lee, Jun Young, Wonju Severance Christian Hospital, Wonju, Gangwon-do, Korea (the Republic of)
  • Yang, Jae Won, Wonju Severance Christian Hospital, Wonju, Gangwon-do, Korea (the Republic of)
  • Han, Byoung Geun, Wonju Severance Christian Hospital, Wonju, Gangwon-do, Korea (the Republic of)
  • Choi, Seung-Ok, Wonju Severance Christian Hospital, Wonju, Gangwon-do, Korea (the Republic of)
  • Kim, Jae seok, Wonju Severance Christian Hospital, Wonju, Gangwon-do, Korea (the Republic of)
Background

Continuous renal replacement therapy (CRRT) is an effective treatment for critically ill patients with acute kidney injury (AKI). However, CRRT circuit is frequently clotted despite anticoagulation resulting in blood loss and reduced dialysis efficacy. We aim to investigate the clinical factors affecting CRRT circuit survival.

Methods

A total of 117 CRRT circuit cases from 102 patients were reviewed retrospectively. We collected clinical data and investigated the factors affecting (1) the time from CRRT start to first dialysis circuit clotting or (2) frequency of circuit exchange during CRRT operation.

Results

The average time to 1st clotting was 26.1 hours. In Kaplan-Meier estimation, AKI due to trauma was related to shorter CRRT circuit survival (p=0.016), while DIC condition was related to longer survival (p=0.061) (Figure 1). In multivariate Cox-regression analysis, it was confirmed that the higher filtration fraction (FF) is associated with the shorter circuit lifespan, while the higher DIC score or corrected calcium level were associated with the longer circuit survival (Table 1). The average number of circuit exchange was 1.46. In multivariate linear regression test adjusted for age, FF, DIC score and RBC transfusion, it was shown that FF had the positive correlation with frequent circuit exchanges (β=0.272, p=0.026), while DIC score had the negative correlation (β= - 0.287, p=0.019).

Conclusion

The study indicates CRRT circuit survival depends on factors related to intra-dialyzer condition such as FF or clotting tendency rather than clinical severity of patients. Interestingly, our results suggest that consumptive coagulopathy due to DIC rather prevents circuit clotting. Low corrected calcium is also thought to be due to consumption as a clotting factor and therefore predict early CRRT circuit clotting.