Successful weaning from continuous renal replacement therapy. Associated risk factors

J Crit Care. 2018 Jun:45:144-148. doi: 10.1016/j.jcrc.2018.02.009. Epub 2018 Feb 16.

Abstract

Purpose: To identify risk factors of successful continuous renal replacement therapy (CRRT) weaning and to evaluate the effect of furosemide in the recovery of urine output after CRRT stop.

Materials and methods: Retrospective, observational study of critical patients treated with CRRT. Weaning tests (WT) were classified in two groups: successful (urine output was recovered and CRRT was not required again) and failed (CRRT was required again). A multiple logistic regression model was used to identify risk factors of successful CRRT WT. The prediction ability was assessed with the area under the receiver operating characteristic curves (AUC-ROC).

Results: Eighty-six patients underwent 101 CRRT WT. The multivariate model identified that the risk factors of successful CRRT weaning were sex and 6h-urine output after CRRT stop. The AUC-ROC was 0.81 (0.72-0.90) for 6h-urine output before and 0.91 (0.84-0.96) for 6h-urine output after CRRT stop. The AUC-ROC for 6h-urine output after WT to predict successful CRRT weaning were 0.94 (0.88-1.0) in patients who received furosemide and 0.85 (0.72-0.99) in patients who did not.

Conclusions: Urine output after CRRT stop was the main risk factor of successful CRRT weaning. Administration of furosemide increased the strength of this association.

Keywords: Acute kidney injury; Continuous renal replacement therapy; Critical patients; Weaning test.

Publication types

  • Observational Study

MeSH terms

  • Acute Kidney Injury / therapy*
  • Acute Kidney Injury / urine
  • Adult
  • Aged
  • Diuretics / administration & dosage
  • Female
  • Furosemide / administration & dosage
  • Humans
  • Logistic Models
  • Middle Aged
  • Multivariate Analysis
  • ROC Curve
  • Renal Dialysis
  • Renal Replacement Therapy*
  • Retrospective Studies
  • Risk Factors
  • Sex Factors
  • Withholding Treatment*

Substances

  • Diuretics
  • Furosemide