Acute renal replacement therapy in cardiogenic shock: Prognostic impact of timing, modality, and indications – Insights from the FRENSHOCK study
Main finding · 30-day mortalityResult — go to the resultHazard ratio 3.19 CI 2.07–4.92Authors' conclusion
Acute RRT in CS is associated with increased mortality. Clinical indications for dialysis identify distinct prognostic subgroups, emphasizing the need to explore cardiorenal sub-phenotypes.
Study context
- Population
- Patients with cardiogenic shock (CS), 49 centres
- Participants
- 772 patients · 49 centres
- Exposure
- Acute renal replacement therapy (RRT) vs no RRT
- RRTn = 114
- Outcome
- Mortality
- Follow-up
- 30 days
Methodological detailsFRENSHOCK, 1:1 propensity-matched cohort
- FRENSHOCK
- 1:1 propensity-matched cohort
Main finding
30-day mortality
Hazard ratio
3.19
CI 2.07–4.92
P < 0.01
RRT vs No RRT
HR 3.19 (CI 2.07–4.92); P < 0.01
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | HR (CI) | P value | |
|---|---|---|---|
| 30-day mortality by RRT indication (acidosis/hyperkalemia vs fluid overload/oliguria) | 1.99 (1.08–2.68) | P = 0.02 | |
| 0.20.5125Hazard ratio (log scale) |
30-day mortality by RRT timing (early ≤48 h vs late >48 h)
- Timing did not significantly impact mortality
30-day mortality by RRT modality (continuous vs intermittent)
- Modality did not significantly impact mortality
Independent predictors of RRT
- Elevated bilirubin, severe anemia, advanced CKD, infectious trigger, epinephrine use, mechanical ventilation, mechanical circulatory support
- Multivariable logistic regression
Original publication
Acute renal replacement therapy in cardiogenic shock: Prognostic impact of timing, modality, and indications – Insights from the FRENSHOCK study. J Crit Care. Published 17 December 2025. doi:10.
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