ScholarWorks@성균관대학교

초록

BackgroundNegative fluid balance during continuous renal replacement therapy (CRRT) is associated with improved clinical outcomes. The effects of negative fluid balance in patients with heterogeneous characteristics undergoing CRRT remain unknown.MethodsThis retrospective study included 2658 adult patients who received CRRT for >= 4 days between 2009 and 2020. Patients were divided according to disease category. Fluid balance was assessed using percent change in body weight (PCB) or cumulative input/output (I/O). Primary outcome was 90-day mortality.ResultsMore positive PCB results in the fluid overload phase and fewer negative PCB results in the fluid removal phase were associated with mortality. A less negative PCB in the fluid removal phase was associated with mortality in medical patients (odds ratio [OR]: 1.052; 95% confidence interval [CI]: 1.023-1.082, and p = 0.001 in the medical patients and OR: 1.064; 95% CI: 1.011-1.120, and p = 0.017 in cardiovascular medical patients) but not in surgical patients. In patients with discrepancies between PCB and cumulative I/O, PCB was associated with mortality, which was consistent with the overall pattern; however, cumulative I/O was not associated with mortality.ConclusionsEarly negative fluid balance is associated with better survival in medical patients but not in surgical patients, who may require more careful fluid balance.

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