Abstract: SA-PO080
Associations Between Blood Pressure Variability and Renal Recovery and Mortality During Continuous Renal Replacement Therapy
Session Information
- AKI: Epidemiology, Risk Factors, Prevention - II
November 04, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 101 AKI: Epidemiology, Risk Factors, and Prevention
Authors
- Kim, Ji Eun, Inha University Hospital, Incheon, Korea (the Republic of)
- Kim, Kipyo, Inha University Hospital, Incheon, Korea (the Republic of)
Background
Acute kidney injury (AKI) requiring dialysis is frequently occurred in critically ill patients, leading to chronic kidney disease progression and dialysis dependency. Blood pressure variability (BPV) has been known to contribute the development of AKI by impairing kidney perfusion. However, the association between short-term and long-term BPV and AKI recovery and mortality remains uncertain.
Methods
We enrolled the patients aged ≥18 years who underwent continuous renal replacement therapy (CRRT) due to AKI for ≥24 hours at Inha University Hospital from January 1, 2018 to December 31, 2020. Patients with end-stage kidney disease were excluded. We extracted 1-hour-interval blood pressure records during CRRT and calculated several BPV parameters including standard deviation (SD), coefficient of variation (CV), average real variability (ARV), and variation independent of mean (VIM). Outcomes are in-hospital mortality and dialysis dependence at the time of discharge. Multivariable logistic regression and Cox proportional hazard analysis were poerformed.
Results
A total of 243 patients were included in the main analysis. Mean age was 69.7 years and male was 56.8%, and 52.2% were sepsis-associated AKI. Median duration of CRRT was 4 days. Multivariable logistic regression showed a significant association between four BPV parameters and dialysis dependence at discharge (SD, OR 1.94 (95% CI 1.07-3.59); CV, OR 2.69 (95% CI 1.47-5.06); VIM, OR 1.92 (95% CI 1.06-3.54), ARV, OR 1.90 (95% CI 1.03-3.54)). These parameters also showed close associations with in-hospital mortality in cox-proportional hazard analysis (SD, HR 1.74 (95% CI 1.25-2.43); CV, HR 2.17 (95% CI 1.55-3.03); VIM, HR 1.77 (95% CI 1.27-2.47), ARV, HR 1.65 (95% CI 1.17-2.32)).
Conclusion
BPV during CRRT was found to be an independent predictor of dialysis dependence at discharge and in-hospital mortality in AKI patients who underwent CRRT. Minimizing BPV during CRRT might be an important factor for recovery to dialysis independence and patient survival.