Background: Acute kidney injury (AKI) increases morbidity and mortality for patients in intensive care units (ICUs). The standard treatment for severe acute kidney injury is renal replacement therapy, where continuous renal replacement therapy (CRRT) is mostly used for patients with hemodynamic instability. However, variations in the mortality rates of patients with AKI undergoing CRRT have raised concerns about the risk factors associated with mortality. The diversity of these factors discussed in the literature on this topic have not led to a consensus.
Purpose: This study explored the risk factors associated with mortality for patients with AKI requiring CRRT in the ICU.
Methods: This is a retrospective study analyzing electronic medical records for 280 patients admitted to the ICU at a university medical center in Vietnam from July 2017 to July 2020. Eligible patients were at least 18 years old, diagnosed with acute kidney injury, and experienced the first CRRT in this hospital. The patient's demographic information, patient status, and clinical characteristics were retrospectively collected from the medical records. Logistic regression was used to determine the risk factors associated with mortality.
Result: Among the 280 participants, 57.86% of them died within seven days after starting CRRT. The majority of the participants were male (62.8%); the mean age was 71.24 years old, and the most common comorbidities were cardiovascular disease and hypertension (46.8%). Most characteristics of the mortality group were less clinically relevant as compared to those in the survivor group. Seven variables predicted mortality: age (OR 1.06, p= 0.008), cardiovascular disease (OR 3.05, p= 0.02), COPD (OR 0.14, p= 0.03), the SOFA score (OR 1.23, p= 0.04), PaO2/FiO2 at admission (OR 1.01, p= 0.009), a positive fluid balance on the first day of CRRT (OR 21.09, p= 0.004), and total days receiving CRRT (OR 0.37, p< 0.001).
Conclusion: Patients with AKI undergoing CRRT who died within 7 days after starting CRRT had several predictors that can be attended to at both ICU admission and CRRT initiation.
Keywords: continuous renal replacement therapy, Acute Kidney Injury, mortality, Intensive Care Unit, prognosis factor.

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