Abstract: TH-PO0714
Mortality and Predictors of Outcomes in Patients in the Intensive Care Unit with AKI Requiring CKRT on Extracorporeal Membrane Oxygenation
Session Information
- AKI: Prevention, Diagnostics, and Management
October 22, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 101 AKI: Epidemiology, Risk Factors, and Prevention
Authors
- Alqallaf, Ali, Temple University, Philadelphia, Pennsylvania, United States
- Alshamali, Mohammad, Temple University, Philadelphia, Pennsylvania, United States
- Gillespie, Avrum, Temple University, Philadelphia, Pennsylvania, United States
Background
Acute kidney injury (AKI) is a common and serious complication in critically ill patients receiving extracorporeal membrane oxygenation (ECMO), and is associated with increased morbidity and mortality. Continuous renal replacement therapy (CRRT) is often used in ECMO patients with AKI to manage renal dysfunction, fluid overload, and metabolic disturbances. This study aimed to assess mortality risk and identify clinical and laboratory markers associated with survival among intensive care unit (ICU) patients with AKI requiring CRRT, including those receiving ECMO, so prognosis could be discussed with families and treatment teams.
Methods
We conducted a single-center retrospective cohort study of adult patients with acute kidney injury (AKI). Patients who were not mechanically ventilated or who had pre-existing end-stage kidney disease (ESKD) or liver cirrhosis were excluded. Clinical, demographic, and laboratory data were collected, and outcomes such as length of stay (LOS) and in-hospital mortality were analyzed.
Results
A total of 2,003 patients with AKI requiring CRRT in the ICU were included, 170 (8.5%) received ECMO support. Mortality was 75.9% in those receiving ECMO compared with 67.3% in non-ECMO patients. Length of stay (LOS) was longer in ECMO patients, at 33.4 days versus 22.5 days in non-ECMO patients (p = 0.001). The unadjusted odds ratio (OR) for mortality in ECMO patients was 1.52 (95% CI 1.07–2.22; p = 0.02), while the adjusted OR for ECMO use was 1.97 (95% CI 1.33–2.92; p < 0.001). After adjusting a priori for age, older age (OR 1.03 per year; 95% CI 1.02–1.04; p < 0.001), higher BMI (OR 1.03 per kg/m^2; 95% CI 1.01–1.04; p < 0.001), and increasing vasopressor use (one: OR 2.17, 95% CI 1.71–2.75, p < 0.001; two: OR 4.02, 95% CI 2.99–5.40, p < 0.001; three: OR 5.49, 95% CI 3.48–8.65, p < 0.001; four: OR 6.56, 95% CI 3.01–14.29, p < 0.001) were associated with mortality. Higher serum albumin (OR 0.65 per g/dL; 95% CI 0.56–0.75; p < 0.001) and male sex (OR 0.79; 95% CI 0.64–0.98; p = 0.029) were associated with lower odds of mortality.
Conclusion
AKI patients requiring CRRT with ECMO had nearly twice the odds of mortality versus those on CRRT alone. Other clinical variables, such as vasopressor burden, BMI, and serum albumin, may further influence outcomes and should be included in risk stratification to identify candidates who may benefit most from dual extracorporeal therapies.