Fluid Overload at RRT Initiation Ups AKI Patients' Long-Term Mortality

Japanese study demonstrates a 2-fold increased risk of death from any cause.
Japanese study demonstrates a 2-fold increased risk of death from any cause.

Fluid overload at the start of renal replacement therapy (RRT) for patients with acute kidney injury (AKI) is associated with worse long-term survival, investigators reported at the European Renal Association-European Dialysis and Transplant Association 53rd Congress in Vienna.

In a retrospective cohort study, Masataka Hasegawa, MD, and collaborators at St. Luke's International Hospital in Tokyo, Japan, found that patients with fluid overload at RRT initiation had a 2-fold increased risk of all-cause mortality compared with those who did not have fluid overload, after adjusting for sex, estimated glomerular filtration rate at admission, Charlson co-morbidity index, and other confounders. The patients with fluid overload also had a 2-fold increased risk of 90-day all-cause mortality.

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The study included 211 adult AKI patients who required RRT from January 2004 to December 2014. Patients were followed up to December 2015. Of the 211 patients, 137 (62%) died during a median 1,279 days of follow-up.

The researchers defined fluid overload at RRT initiation as a greater than 10% increase in body weight compared with baseline.

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