#5267 INITIAL EMERGENCY ROOM 6-HOUR URINE VOLUME IS AN IMPORTANT FACTOR FOR THE SURVIVAL OF CRITICALLY ILL PATIENTS UNDERGOING CRRT

Abstract

Abstract Background and Aims It has been little known whether initial emergency room factors affect survival or renal function in critically ill patients undergoing continuous renal replacement therapy. We examined whether initial factors in ER impact survival and renal recovery in critically ill patients undergoing continuous renal replacement therapy. Method The study was a single-center, retrospective study of 332 patients for critically ill patients admitted to ICUs for continuous renal replacement therapy via emergency room from March 1, 2018 to May 31, 2021. Clinical parameters including urine output, eGFR, and serum NGAL were identified. The primary outcomes were the 30-day and 90-day mortality. Secondary outcomes were the 30-, and 90-day dialysis-free duration. Results Low urine output (LUO, defined as < 0.5 mL/kg/hr x 6 hours) group was significantly associated with 30-day mortality and 90-day mortality. Multivariable Cox regression analysis showed that LUO group was significantly more associated with the increased risk of 30-day mortality and 90-day mortality (hazard ratio, 1.935 and 2.141, respectively) compared to high urine output (HUO, defined as ≥ 0.5 mL/kg/hr x 6 hours) group. There was no significant association between 30-day or 90-day mortality and initial estimated glomerular filtration rate (eGFR) plasma neutrophil gelatinase-associated lipocalin (NGAL) levels. In critically ill patients undergoing continuous renal replacement therapy, HUO group and initial eGFR ≥ 30 ml/min/1.73m2 groups was associated with decreased 30-, and 90-day dialysis-free duration. However, serum NGAL had no significant relation with 30-, and 90-days RRT free durations. Conclusion During admission to emergency room, the initial low urine output is an important factor for 30-day and 90-day mortality in Critically Ill Patients Undergoing Continuous Renal Replacement Therapy.