Predictive value of renal resistance index on the timing of CRRT weaning in patients with acute kidney injury in ICU

Abstract

Abstract Background: Few studies have been undertaken to establish the optimal time for discontinuing continuous renal replacement therapy (CRRT) in individuals with acute kidney injury (AKI). This study aimed to find prospective renal biomarkers or clinical signs that could indicate successful CRRT deconditioning. Methods： A prospective observational study was carried out on 45 patients wt CRRT who discontinued following renal recovery. When patients did not require CRRT for at least 7 days, they were regarded as successfully discharged. Patients who resumed dialysis within seven days were deemed unsuccessful. Results: 24 (53.3%) of the 45 patients examined were successfully released from CRRT. The 24-h urine volume after weaning cessation, the renal resistance index (RRI) after cessation, and the creatinine ratio on the day of weaning and the day following weaning were determined to be variables impacting the effectiveness of CRRT cessation in a multivariate model. The RRI AUC-ROC after CRRT discontinuation was 0.872 (0.76 -0.99), and the 24-h urine volume AUC-ROC was 0.929. (0.84-1.00). The AUC-ROC for the 24-h urine volume after CRRT discontinuation was 0.929 (0.84-1.00), and the creatinine ratio on the first day following CRRT cessation vs the day of weaning was 0.643 (0.476-0.810). Conclusions: RRI was the main risk factor of successful CRRT weaning.