Abstract: FR-PO123
Impact of Positive Fluid Balance and Timing of Renal Replacement Therapy in AKI in a Real-Life Scenario
Session Information
- AKI: Outcomes, RRT
November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 102 AKI: Clinical, Outcomes, and Trials
Authors
- Rodelo Ceballos, Joaquin, Universidad de Antioquia, Medellin, Colombia
- Gomez Gil, Jean Paul Paul, Universidad de Antioquia, Medellin, Colombia
- Arteaga Mejía, Carlos Alberto, Universidad de Antioquia, Medellin, Colombia
- Zapata Cardenas, Andres Alberto, Universidad de Antioquia, Medellin, Colombia
- León, Alba Luz, Universidad de Antioquia, Medellin, Colombia
- Jaimes, Fabian, Universidad de Antioquia, Medellin, Colombia
Background
Objective: To determine if a fluid overload of less than 10% of body weight and early initiation (<12 hours ) of RRT behave as an independent prognostic factor for mortality in patients with AKI KDIGO 3 in the ICU.
Methods
Retrospective cohort study that included patients hospitalized in the ICU of a hospital in Medellín-Colombia with a diagnosis of AKI KDIGO 3 and need for RRT.
Results
278 patients with a median age of 63 years, 58.6% (163) men and 60.4% (168) diagnosed with sepsis were included. 166 (59.7%) were classified as early RRT and 112 (40.3%) as late RRT. The cumulative fluid balance was 9565 ml and 7496 ml, respectively. Mortality was 69% (192), with no significant differences according to the time of RRT (67 vs. 71%). There were no statistically significant differences between the early and late therapy group (OR adjusted 1.34, 0.65-2.75); nor in those with a percentage of accumulated fluid balance greater than 10% of body weight (OR adjusted 1.27; CI 0.73-2.23).
Conclusion
Early initiation of RRT, less than 12 hours from diagnosis, and with an accumulated fluid balance of less than 10% of body weight, did not have a lower risk of in-hospital mortality in patients with AKI KDIGO 3 in the ICU.
| Variable | OR crude | OR adjusted |
| Early RRT | 1.07 (0.56-2.06) | 1.34 (0.65-2.75) |
| Fluid Balance >10% of body weight at RRT | 1.49 (0.88-2.52) | 1.27 (0.73-2.23) |
| Age | 1.01 (0.99-1.03) | 1.03 (1.01-1.05) |
| Charlson Index | 0.90 (0.81-1.00) | 0.82 (0.71-0.95) |
| Modality of RRT: HDFVVC | 1.28 (0.92-1.79) | 1.21 (0.81-1.79) |
| Sepsis | 1.19 (0.72-1.99) | 1.02 (0.56-1.85) |
| SOFA | 1.07 (1.00-1.14) | 1.02 (0.95-1.11) |
| APACHE II | 1.01 (0.98-1.04) | 1.01 (0.98-1.05) |