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논문분류	춘계학술대회 초록집
제목	Optimal Hemoglobin Threshold and In-Hospital Mortality in Acute Kidney Injury Patients Receiving Continuous Kidney Replacement Therapy
저자	Hyun Lee Ko
출판정보	2026; 2026(1):
키워드	Acute Kidney Injury, Continuous Kidney Replacement Therapy, Hemoglobin, In-hospital mortality, Optimal Hemoglobin threshold
초록	Objectives: Anemia is common in critically ill patients with acute kidney injury (AKI), particularly those receiving continuous kidney replacement therapy (CKRT). Kidney dysfunction, systemic inflammation, impaired erythropoiesis, and ongoing blood loss contribute to reduced hemoglobin (Hb) levels in this population. However, the optimal Hb level during CKRT and its relationship with clinical outcomes remain unclear. We aimed to evaluate the association between average Hb levels during CKRT and in-hospital mortality and to identify a clinically relevant Hb cutoff. Methods: We conducted a retrospective cohort study of 2,755 patients with AKI who received CKRT. The primary outcome was in-hospital mortality. The median Hb level during CKRT was 9.0 g/dL. Hb was analyzed both as a continuous variable (per 1-standard deviation [SD] increase) and as quartiles: Q1 (4–8.25 g/dL), Q2 (8.25–9.0 g/dL), Q3 (9.0–10.1 g/dL), and Q4 (10.1–17.3 g/dL). Multivariable logistic regression was used to estimate adjusted odds ratios (ORs) with 95% confidence intervals (CIs). Results: The mean age was 65.5±15.0 years, and 61.4% were male. Using Q3 as the reference, Q1 was independently associated with increased mortality (adjusted OR 1.87, 95% CI 1.44–2.42, p<0.001), and Q2 also showed a higher risk (adjusted OR 1.28, 95% CI 1.00–1.64, p=0.049). Q4 was not significantly associated with mortality. When analyzed continuously, each 1-SD increase in Hb was associated with lower mortality (adjusted OR 0.81, 95% CI 0.74–0.89, p<0.01). Conclusion: Lower average hemoglobin levels during CKRT were independently associated with increased in-hospital mortality in patients with AKI. An Hb level around 9 g/dL may represent a clinically meaningful Hb threshold for risk stratification in patients receiving CKRT.
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