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논문분류	춘계학술대회 초록집
제목	Long-term clinical impacts of cumulative fluid balance in continuous renal replacement therapy
저자	Jung nam AN1,2, Jin ho HWANG3, Dong ki KIM4, Hajeong LEE4, Shin young AHN5, Sejoong KIM6, Jung tak PARK7, Shin-wook KANG7, Yun kyu OH1, Yon su KIM4, Chun soo LIM1, Hyung jung OH8, *Jung pyo LEE1
출판정보	2017; 2017(1):
키워드	Continuous renal replacement therapy; Acute kidney injury; Fluid balance; Chronic kidney disease progression
초록	Objectives : Renal functional assessment at 3 months after continuous renal replacement therapy (CRRT) initiation can be useful in predicting long-term mortality and progression to ESRD. We investigated the association between fluid balance before and after CRRT initiation and long-term outcomes after acute kidney injury (AKI) episode requiring CRRT. Methods : Among 1764 adult AKI patients started on CRRT from 2009 to 2013 in intensive care units in four tertiary academic hospitals in Korea, 331 survivors at 3 months after CRRT initiation were enrolled. Chronic kidney disease (CKD) progression was defined as a worsening renal status assessed at 3 months after CRRT initiation, comprising RRT continuation, an increase in serum creatinine of more than 50%, and a decrease in the estimated glomerular filtration rate of 35% or more than the baseline values. Results : Cumulative fluid balance during 5 days after CRRT initiation was not associated with CKD progression. However, a positive fluid balance during 24 hours before CRRT initiation had the protective effect for CKD progression [Odds ratio 0.46 (0.23-0.91); P = 0.026]. This result was significant after adjustment for gender, age, and baseline serum creatinine. During the median 20.4 (7.5-39.7) months of follow-up, fluid balance was not associated with the long-term mortality. Conclusions : Cumulative fluid balance after CRRT initiation was not associated with the long-term clinical outcomes. However, positive fluid balance during 24 hours before CRRT initiation was a favorable factor for CKD progression. The monitoring and management of fluid balance before CRRT initiation could be important.
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