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Kidney Week

Abstract: FR-PO132

Effect of Urinary Output on Withdrawal from Continuous Renal Replacement Therapy in a Tertiary Referral Center in Western Mexico

Session Information

  • AKI: Outcomes, RRT
    November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Acute Kidney Injury

  • 102 AKI: Clinical, Outcomes, and Trials

Authors

  • Parra Guerra, Ricardo, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, Mexico
  • Banda Lopez, Adriana, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, Mexico
  • Rojas-Campos, Enrique, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, Mexico
  • Gonzalez-Correa, Luis Gerardo, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, Mexico
  • Carvallo Venegas, Mauricio, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, Mexico
  • Andrade-Sierra, Jorge, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, Mexico
  • Mendoza Cabrera, Salvador, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, Mexico
  • Acevedo, Miguel, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, Mexico
  • Bautista Melo, Berenice, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, Mexico
  • Cruz Landino, Moises, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, Mexico
Background

The withdrawal of Continuous Renal Replacement Therapy (CRRT) in patients with severe AKI has not been standardized. New evidence suggests that releasing CRRT too soon, as well as unneeded and extended CRRT, might negatively affect the clinical course and economic cost of AKI.

Methods

A retrospective cohort of critically ill adult patients hospitalized in four intensive care units of a tertiary care center in western Mexico, who presented with acute kidney injury requiring CRRT, in which renal replacement therapy (RRT) was interrupted without the intention of migrating to another form of RRT, from January 2016 to March 2021. We defined CRRT withdrawal success as 72 h without the need for a TRR reset after CRRT discontinuation.

Results

Fifty-two patients who met the inclusion criteria were evaluated. Due to the abnormal distribution of the uresis values in both groups, it was decided to carry out the analysis by quartiles, finding the distribution regarding the success or failure of CRRT withdrawal. We found that uresis below the first quartile (<1,200 ml) was a risk factor for failure to withdraw CRRT (OR 2.85, 95% CI 1.84-4.41, p<0.001). Other variables that showed a risk of CRRT withdrawal failure in the multivariate analysis were lower systolic and diastolic blood pressure, the presence of comorbidities, more total hours of CRRT, and absence of diuretic use at the time of CRRT withdrawal.

Conclusion

A urine output of less than 1 liter was associated with almost three times the risk of failure to withdraw CRRT in our population. In turn, diuretics use facilitated withdrawal. Urinary volumes were greater in our CRRT-withdrawing study compared to those reported in other places.