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논문분류	춘계학술대회 초록집
제목	Predictive factors for successful discontinuation of continuous renal replacement therapy in acute kidney injury
저자	Song In Baeg1, Hyo Jin Boo1, Eun Jung Lee2, Jung Eun Lee2, Wooseong Huh2, Dae Joong Kim2, Yoon-Goo Kim2, Ha Young Oh2, Hye Ryoun Jang2
출판정보	2018; 2018(1):
키워드	AKI \| CRRT \| Discontinuation \| Predictive factor
초록	Objectives: Although continuous renal replacement therapy (CRRT) is a standard treatment for severe acute kidney injury (AKI) in critically ill patients, the strategy for discontinuing CRRT is sparse. Predictive factors for successful discontinuation of CRRT was evaluated. Methods: Adult patients (≥18 years) who received CRRT at Samsung Medical Center from June 2007 to June 2017 were included (n=3060). Patients with preexisting end stage renal disease (ESRD), patients who progressed to ESRD within 1 year after CRRT discontinuation, or died within 7 days were excluded. Successful discontinuation of CRRT was defined as no requirement of RRT for 7 days after stopping CRRT. Patients were divided into the failure group and the success group. Clinical information and laboratory results were collected by using electronic medical records. Results: A total of 1017 patients were analyzed. Baseline serum creatinine was lower in the success group (failure vs. success: 3.52±2.29 vs. 2.90±2.11 mg/dL, p<0.001). Urine output at CRRT initiation was higher in success group (397 vs. 650 mL/day, p<0.001). There were no differences in comorbidities. The duration of CRRT was longer in the failure group (p<0.001). Mean arterial pressure on discontinuation day (D0) was lower in the success group (80.7 ± 12.6 vs. 78.5 ± 12.8 mmHg, p=0.006). Urine output on the day before discontinuation (D-1) (134 vs. 612 mL/day, p<0.001) and D0 (250 vs.1255 mL/day, p<0.001) and the proportion of patients who received vasopressors on D-1 (26.0% vs. 39.2%, p<0.001) and D0 (19.0% vs. 33.9%, p<0.001) were higher in the success group. Serum potassium on D-1 (4.01 ± 0.45 vs. 3.93 ± 0.48, p=0.005) and D0 (4.02 ± 0.44 vs. 3.89 ± 0.45, p<0.001) was lower in the success group. Conclusions: Our study identified greater urine output, use of vasopressors, and lower but normal potassium levels as predictive factors of successful CRRT discontinuation.
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