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논문분류	춘계학술대회 초록집
제목	Fluid balance after two days of continuous renal replacement therapy initiation is a predictor of 28-day mortality – multicenter cohort study
저자	Jung Nam An1, Sohee Oh2, Hyung Jung Oh6, Jung Pyo Lee1, Dong Ki Kim5, Dong-Ryeol Ryu4, Sejoong Kim3
출판정보	2018; 2018(1):
키워드	Fluid balance \| Continuous renal replacement th \| 28-day mortality \| Multicenter cohort
초록	Objectives: Cumulative fluid balance is associated with the risk of mortality in severe acute kidney injury (AKI) patients undergoing continuous renal replacement therapy (CRRT). However, there is no index to accurately measure the fluid balance status. We examined the fluid balance by time using bioimpedance analysis and investigated the association with clinical outcomes in the CRRT patients. Methods: In this multicenter cohort study, a total of 179 AKI patients undergoing CRRT were enrolled from May 2017 to January 2018. Bioimpedance analyses were performed and the values of total body water/height2 (TBW/H2, L/m2) were collected at the time of CRRT initiation (Day 0), Day 1, Day 2, and Day 7. Demographics, comorbidities, various parameters related to CRRT, laboratory data, and clinical outcomes were extracted from electronic medical records. Results: Mortality at 28 days after CRRT initiation was 48.6%, and more fluid overload at CRRT initiation (D0) was associated with mortality (Odds ratio [OR], 2.26; 95% confidence interval [95% CI], 1.04-4.90; P = 0.040). In the analysis of the patients with available data measured at day 2, TBW/H2 at day 2 was significantly associated with risk for 28-day mortality (OR, 1.22; 95% CI, 1.01-1.48; P = 0.040). Multivariate analysis adjusting for age, sex, comorbidities, APACHE II score, and SOFA score revealed that TBW/H2 after 2 days of CRRT initiation was a potential predictor for 28-day mortality. Conclusions: This study demonstrated that fluid overload, defined as TBW/H2, at 2 days after CRRT initiation might contribute to increase 28-day mortality. Further studies will be needed.
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