Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/32776
Title: Impact of Continuous Renal Replacement Therapy Initiation on Urine Output and Fluid Balance: A Multicenter Study.
Austin Authors: White, Kyle Christopher;Laupland, Kevin B;See, Emily J ;Serpa Neto, Ary ;Bellomo, Rinaldo 
Affiliation: Intensive Care Unit, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.;Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia.
Department of Intensive Care Services, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.;Queensland University of Technology (QUT), Brisbane, Queensland, Australia.
School of Medicine, University of Melbourne, Melbourne, Victoria, Australia.;Department of Critical Care, University of Melbourne, Melbourne, Victoria, Australia.;
Department of Critical Care, University of Melbourne, Melbourne, Victoria, Australia.;Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.;Department of Critical Care Medicine, Hospital Israelita Albert Einstein, São Paulo, Brazil.
Intensive Care
Department of Nephrology, The Royal Melbourne Hospital, Parkville, Victoria, Australia.
Department of Nephrology, The Royal Children's Hospital, Parkville, Victoria, Australia.
Issue Date: 18-Apr-2023
Date: 2023
Publication information: Blood Purification 2023; 52(6)
Abstract: The effect of continuous renal replacement therapy (CRRT) on renal function is poorly understood. However, the initiation of CRRT may induce oliguria. We aimed to investigate the impact of CRRT commencement on urine output (UO). This was a retrospective cohort study in two intensive care units. We included all patients who underwent CRRT and collected data on hourly UO and fluid balance before and after CRRT commencement. We performed an interrupted time series analysis using segmented regression to assess the relationship between CRRT commencement and UO. We studied 1,057 patients. Median age was 60.7 years (interquartile range [IQR], 48.3-70.6), and the median APACHE III was 95 (IQR, 76-115). Median time to CRRT was 17 h (IQR, 5-49). With start of CRRT, the absolute difference in mean hourly UO and mean hourly fluid balance was -27.0 mL/h (95% CI: -32.1 to -21.8; p value < 0.01) and - 129.3 mL/h (95% CI: -169.2 to -133.3), respectively. When controlling for pre-CRRT temporal trends and patient characteristics, there was a rapid post-initiation decrease in UO (-0.12 mL/kg/h; 95% CI: -0.17 to -0.08; p value < 0.01) and fluid balance (-78.1 mL/h; 95% CI: -87.9 to -68.3; p value < 0.01), which was sustained over the first 24 h of CRRT. Change in UO and fluid balance were only weakly correlated (r -0.29; 95% CI: -0.35 to -0.23; p value < 0.01). Commencement of CRRT was associated with a significant decrease in UO that could not be explained by extracorporeal fluid removal.
URI: https://ahro.austin.org.au/austinjspui/handle/1/32776
DOI: 10.1159/000530146
ORCID: 
Journal: Blood Purification
Start page: 1
End page: 9
PubMed URL: 37071971
ISSN: 1421-9735
Type: Journal Article
Subjects: Acute kidney injury
Continuous renal replacement therapy
Critical care
Appears in Collections:Journal articles

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