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Abstract: SA-PO0352

Key Factors in Posthospitalization Dialysis Dependence in Patients on Extracorporeal Membrane Oxygenation (ECMO)-CRRT

Session Information

Category: Dialysis

  • 801 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Kashani, Mehdi, Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Wei, Lifang, Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Singh, Waryaam, Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Kashani, Kianoush, Mayo Clinic Minnesota, Rochester, Minnesota, United States
Background

Patients requiring both ECMO and continuous renal replacement therapy (CRRT) represent a high risk for poor renal outcomes. While acute kidney injury (AKI) is common in this group, the long-term risk of dialysis dependence after discharge remains understudied.

Methods

We conducted a retrospective cohort study of adult patients who received both ECMO and CRRT at a tertiary medical center between 2015 and 2022. Patients with pre-existing end-stage renal disease were excluded. The primary outcome was dialysis dependence in a 120-day follow-up after discharge. Logistic regression was used to identify factors associated with persistent dialysis dependence.

Results

Of 191 patients requiring ECMO and CRRT, 85 (45%) survived to discharge. Among them, 18 (21%) remained dialysis dependent at 120 days[KK1] . These patients had significantly longer hospital stays (87.6 vs. 53.6 days, p = 0.001) and longer CRRT durations. Multivariate analysis showed hospital length of stay was independently associated with dialysis dependence (OR 1.02, 95% CI 1.004–1.041, p = 0.0046).

Conclusion

Approximately one in five ECMO-CRRT survivors remained dialysis dependent four months after discharge. Prolonged hospitalization was the strongest predictor of continued dialysis need, highlighting the long-term burden of critical illness and the importance of early post-discharge nephrology follow-up.

Digital Object Identifier (DOI)