Kidney Week

Abstract: FR-PO0071

Evaluating Real-World Data of CRRT Dose Prescription: Results from the CRRTnet Registry

Session Information

• AKI: Epidemiology, Risk Factors, and Prevention
  November 07, 2025 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Acute Kidney Injury

• 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

• Nombera, Natalia R., The University of Alabama at Birmingham, Birmingham, Alabama, United States

Natalia R. Nombera, MD

• Lambert, Joshua, University of Cincinnati, Cincinnati, Ohio, United States

Joshua Lambert, PhD

• Rewa, Oleksa G., University of Alberta, Edmonton, Alberta, Canada

Oleksa G. Rewa, MD, MS

• Heung, Michael, University of Michigan, Ann Arbor, Michigan, United States

Michael Heung, MD, MS, FASN

• House, Andrew A., London Health Sciences Centre, London, Ontario, Canada

Andrew A. House, MD, MS, FASN

• Juncos, Luis A., University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States

Luis A. Juncos, MD, FASN

• Takeuchi, Tomonori, The University of Alabama at Birmingham, Birmingham, Alabama, United States

Tomonori Takeuchi, MD

• Nadkarni, Girish N., Icahn School of Medicine at Mount Sinai, New York, New York, United States

Girish N. Nadkarni, MD, MPH

• Chan, Lili, Icahn School of Medicine at Mount Sinai, New York, New York, United States

Lili Chan, MD, MS

• Goldstein, Stuart, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States

Stuart Goldstein, MD, FASN

• Bagshaw, Sean M., University of Alberta, Edmonton, Alberta, Canada

Sean M. Bagshaw, MD

• Neyra, Javier A., The University of Alabama at Birmingham, Birmingham, Alabama, United States

Javier A. Neyra, MD, MS, FASN

Background

While current guidelines recommend CRRT delivered dose of 20-25 ml/kg/h, practice variations on prescribed dose exist. This study aims to examine CRRT dose practice patterns and the relationship with clinical characteristics and outcomes.

Methods

CRRTnet is a multicenter observational study of adults receiving CRRT. We included patients aged 18-89 years who underwent CRRT for >1 day and excluded those with ESRD. We utilized linear and logistic regression models to evaluate clinical characteristics associated with CRRT dose and clinical outcomes, respectively.

Results

931 patients corresponding to 6,166 CRRT patient-days were analyzed. The cohort consisted of 40% women and had a median age of 61 years, Charlson index of 2 (IQR: 1-4) and SOFA score at CRRT initiation of 15 (13-17). In-hospital mortality was 53.1% and among survivors 55.3% were HD dependent at discharge. Median CRRT initial prescribed dose was 31.1 (25.3-39.4) ml/kg/h with only 23.1% of patients initially prescribed guidelines-concordant CRRT dose. The median duration of CRRT was 4 (2-8) days and the median of the average prescribed CRRT dose throughout CRRT was 32.1 (25.9-40.7) ml/kg/h (Figure 1A). Clinical parameters independently associated with higher CRRT prescribed dose were lower BMI, CRRT indications of uremia and hyperkalemia, vasoactive drug use and %fluid overload at CRRT start (all p<0.01). Higher average prescribed CRRT dose was independently associated with increased in-hospital mortality (aOR 1.02 per 1 mL/kg/h, 95% CI 1.0-1.03, p=0.04) (Figure 1B). Average CRRT dose >30 (vs. ≤30) ml/kg/h had a borderline association with increased risk of in-hospital mortality (aOR 1.37, 0.99-1.90, p=0.06). Among survivors, average prescribed CRRT dose was not associated with HD dependence at discharge.

Conclusion

In this registry, solute and volume CRRT indications as well as vasoactive drug exposure were independently associated with higher CRRT prescribed dose. Higher average prescribed CRRT dose was independently associated with increased risk of in-hospital mortality.

Funding

• NIDDK Support

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.2025d59f348f