Kidney Week

Abstract: SA-PO040

Comparison of Conventional and High-Dose Continuous Kidney Replacement Therapy in Critically Ill Patients with Septic AKI

Session Information

• AKI: Clinical, Outcomes, and Trials - Management
  October 26, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Acute Kidney Injury

• 102 AKI: Clinical, Outcomes, and Trials

Authors

• Jung, Chan-Young, Asan Medical Center, Seoul, Korea (the Republic of)

Chan-Young Jung, MD

• Jung, Jiyun, Dongguk University Ilsan Hospital, Seoul, Gyeonggi-do, Korea (the Republic of)

Jiyun Jung, PhD

• Lim, Jeong-Hoon, Kyungpook National University Chilgok Hospital, Daegu, Korea (the Republic of)

Jeong-Hoon Lim, MD, PhD

• Paek, Jin hyuk, Keimyung University School of Medicine, Daegu, Korea (the Republic of)

Jin hyuk Paek, MD, PhD

• Kim, Kipyo, Inha University Hospital, Incheon, Korea (the Republic of)

Kipyo Kim, MD, PhD

• Kim, Yong Chul, Seoul National University College of Medicine, Seoul, Korea (the Republic of)

Yong Chul Kim, MD, PhD

• Park, Jae Yoon, Dongguk University Ilsan Hospital, Seoul, Gyeonggi-do, Korea (the Republic of)

Jae Yoon Park, MD, PhD

• Kim, Hyosang, Asan Medical Center, Seoul, Korea (the Republic of)

Hyosang Kim, MD, PhD

• Baek, Chung Hee, Asan Medical Center, Seoul, Korea (the Republic of)

Chung Hee Baek, MD

Group or Team Name

• RENERGY.

Background

Although prospective studies have suggested no differences in patient outcomes between high-dose and conventional-dose continuous kidney replacement therapy (CKRT) in critically ill patients undergoing CKRT, real world data are lacking. This study aimed to compare patient outcomes between conventional and high-dose CKRT in critically ill patients with septic acute kidney injury (AKI).

Methods

This multi-center, retrospective, observational cohort study included 1,390 critically ill patients with septic AKI treated with either conventional (<35 mL/kg/h; n =552) or high-dose (≥35 mL/kg/h; n = 838) CKRT. The primary outcome was 28-day mortality. Secondary outcomes included 90-day mortality, CKRT duration, kidney replacement therapy (KRT) dependence at discharge, and intensive care unit (ICU) and hospital stays.

Results

No significant differences were observed for both 28- (52.2% vs. 52.4%, P=0.938) and 90-day (59.8% vs. 61.7%, P=0.475) mortality rates among the conventional and high-dose groups. Compared to the conventional-dose group, the adjusted hazard ratios (95% confidence interval [CI]) for 28- and 90-day mortality were 0.91 (95% CI, 0.78-1.06, P=0.213) and 0.94(95% CI, 0.81-1.08, P=0.383), respectively. The conventional-dose group was associated with both a higher rate of KRT dependence at discharge (17.6% vs. 9.0%, P <0.001) and longer length of ICU stay (median 9.5 vs. 7.0 days, P=0.010), compared to the high-dose group.

Conclusion

While mortality rates did not significantly differ, when compared to conventional-dose CKRT, high-dose CKRT appeared to have lower rates of KRT dependence at discharge and shorter lengths of ICU stays.