• Imré Van Herreweghe, Sikander Texiwala, Ruxandra Pinto, Ron Wald, and AdhikariNeill K JNKJDepartment of Critical Care Medicine, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada; Interdepartmental Division of Critical Care Medicine, University of Toronto, 30 Bond Street, Toronto, ON, M5B 1.
• Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada.
• J Crit Care. 2021 Dec 1; 66: 96-101.

PurposeReliable prediction of early mortality after initiation of renal replacement therapy (RRT) in critically ill patients may inform decision-making regarding this treatment. Our primary objective was to identify predictors of mortality within 2 days of starting RRT.Materials And MethodsPatients with acute kidney injury (AKI), receiving RRT, and admitted to intensive care units of one hospital were included. Associations between baseline risk factors and mortality at 2 days and at hospital discharge were analyzed using logistic regression. Discrimination of both models was assessed.ResultsWe included 626 patients, treated initially with intermittent RRT (n = 300, 47.9%), continuous RRT (n = 211, 33.7%), or sustained low-efficiency dialysis (n = 115, 18.4%). Two-day mortality after starting RRT was 12.9% (n = 81), and hospital mortality was 50.5% (n = 316). Independent predictors of 2-day mortality included primary diagnostic category (p = 0.004) and sepsis-related organ failure assessment (SOFA) score (odds ratio [OR] 1.36 per point, 95% confidence interval [CI] 1.24-1.50). Independent predictors of hospital mortality included SOFA (1.29, 95%CI 1.21-1.37), Charlson score (1.20, 95%CI 1.18-1.43), and interhospital transfer (OR 0.55, 0.38-0.81). C-statistics were 0.81 (2-day mortality) and 0.80 (hospital mortality).ConclusionsHigher SOFA was associated with 2-day mortality after RRT initiation and with hospital mortality. Discrimination in both models was modest.Copyright © 2021 Elsevier Inc. All rights reserved.

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