Abstract: TH-PO0738
Primary Discharge Diagnosis and Outcomes of Critically Ill Adults Receiving CRRT
Session Information
- AKI: Critical Care, CKRT, Cardiorenal Syndromes, and Clinical Outcomes
October 22, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 102 AKI: Clinical, Outcomes, and Trials
Authors
- Shampa, Sadia Yesmin, The University of Alabama at Birmingham, Birmingham, Alabama, United States
- Tolwani, Ashita J., The University of Alabama at Birmingham, Birmingham, Alabama, United States
- Neyra, Javier A., The University of Alabama at Birmingham, Birmingham, Alabama, United States
Background
Continuous renal replacement therapy (CRRT) is frequently used in critically ill patients with diverse acute and chronic conditions, yet outcomes are often reported as one pooled group. We examined whether primary discharge diagnosis was associated with differential mortality risk.
Methods
We conducted a cohort study of 2,444 adults who consecutively received CRRT at UAB between January 2022 and December 2024 (first episode per patient). Among these, 2,168 had AKI and 276 had ESRD. Individual primary discharge diagnosis categories were Sepsis, Liver, Cardiac, Respiratory, Renal, or Other. Primary discharge diagnosis categories were determined using ICD-10 codes; patients not meeting the predefined criteria were classified as Other. We examined in-hospital mortality across categories and performed logistic regression analysis among patients with complete covariate data to adjust for age, sex, race, BMI, mechanical ventilation, CRRT duration, and AKI vs. ESRD status.
Results
Median age was 59 (IQR 47 to 68) and 60.7% were men. Cardiac and Sepsis diagnosis categories were the most common (27.5% and 20.0%), followed by Respiratory (7.6%), Liver (6.2%), and Renal (3.1%); 34.1% fell into Other. In-hospital mortality varied widely, from 43.4% in Renal to 69.5% in Liver categories. In adjusted models in reference to the Cardiac category, patients in the Liver category had more than 2-fold higher odds of mortality (aOR 2.15, 95% CI 1.40 to 3.30, p<0.001) (Figure). AKI status (aOR 3.03, 95% CI 2.19 to 4.27, p<0.001) and older age (aOR 1.025 per year, 95% CI 1.017 to 1.033, p<0.001) were independently associated with increased mortality.
Conclusion
The primary discharge diagnosis category was significantly and differentially associated with in-hospital mortality in critically ill patients on CRRT. Stratification by primary ICU diagnosis can support development of disease-specific prediction models.
Acknowledgment
NIH-NIDDK R01DK133539
NIH-NIDDK U54DK137307
Adjusted mortality and clinical outcomes by primary discharge diagnosis category in adults receiving CRRT
Funding
- NIDDK Support