Predictors for mortality and recovery in patients with acute renal injury receiving continuous renal replacement therapy

Abstract

Objective:Despite continuous renal replacement therapy (CRRT) has been widely used in critically ill patients with acute kidney injury (AKI), the prognosis and recovery of renal function in these patients are still poor. Therefore, we aimed to identify the prognostic factors for the mortality and recovery of renal function in patients with AKI receiving CRRT.Methods:A total of 125 patients with AKI, treated with CRRT in the emergency intensive care unit (EICU) in an academic teaching hospital from January 2014 to December 2018 were enrolled in this retrospective study. The clinical data of these patients were collected. Univariate regression analysis and multivariate regression analysis were conducted to identify the predictors for the mortality and recovery of renal function.Results:The median age was 68.0 (56.5–79.0) years old, and from which 69.6% were males. Sixty-four patients (51.2%) survived and 50 patients (40%) recovered their renal function. Multivariate regression analysis showed that the independent risk factors for mortality were male (odds ratio [OR]:3.771, 95% confidence interval [CI]:1.063–13.372, p = 0.04), Acute Physiology and Chronic Health Evaluation (APACHE) II score (OR: 1.187, 95% CI: 1.050–1.341, p = 0.006), mechanical ventilation (OR: 6.266, 95% CI: 1.771–22.167, p = 0.004) and vasopressor use (OR: 5.224, 95% CI: 1.546–17.657, p = 0.008). Moreover, the independent predictors for not recovering of renal function were male (OR: 3.440, 95% CI: 1.271–9.311, p = 0.015), pre-existing comorbidity of hypertension (OR: 4.207, 95% CI: 1.609-11.000, p = 0.003) and vasopressor use (OR: 5.280, 95% CI: 2.018–13.811, p = 0.001).Conclusions:Male, high APACHE II score, mechanical ventilation and vasopressor use were closely associated with the increased mortality, while male, pre-existing history of hypertension, and vasopressor use were the independent predictors for non-recovery of renal function.