Prognosis of Patients with Acute Kidney Injury due to Type 1 Cardiorenal Syndrome Receiving Continuous Renal Replacement Therapy

Abstract

Introduction: The prognosis of patients with acute kidney injury (AKI) caused by type 1 cardiorenal syndrome (CRS) requiring continuous renal replacement therapy (CRRT) is unclear. We investigated the in-hospital mortality and prognostic factors in these patients. Methods: We retrospectively identified 154 consecutive adult patients who received CRRT for AKI caused by type 1 CRS between January 1, 2013, and December 31, 2019. We excluded patients who underwent cardiovascular surgery and those with stage 5 chronic kidney disease. The primary outcome was in-hospital mortality. Cox proportional hazards analysis was performed to analyze independent predictors of in-hospital mortality. Results: The median age of patients at admission was 74.0 years (interquartile range: 63.0–80.0); 70.8% were male. The in-hospital mortality rate was 68.2%. Age ≥80 years (hazard ratio [HR], 1.87; 95% confidence interval [CI], 1.21–2.87; p = 0.004), previous hospitalization for acute heart failure (HR, 1.67; 95% CI, 1.13–2.46; p = 0.01), vasopressor or inotrope use (HR, 5.88; 95% CI, 1.43–24.1; p = 0.014), and mechanical ventilation at CRRT initiation (HR, 2.24; 95% CI, 1.46–3.45; p < 0.001) were associated with in-hospital mortality. Conclusion: In our single-center study, the use of CRRT for AKI due to type 1 CRS was associated with high in-hospital mortality.