Association of hospital-level continuous kidney replacement therapy use and mortality in critically ill patients with acute kidney injury
Authors' conclusion
Among critically ill adults with AKI requiring KRT, treatment in hospitals with higher CKRT utilization rates was associated with reduced hospital mortality.
Study context
- Population
- Critically ill adults with acute kidney injury (AKI) receiving kidney replacement therapy (KRT) in the intensive care unit (ICU) in US hospitals offering both continuous kidney replacement therapy (CKRT) and intermittent hemodialysis (Premier Incorporated AI (PINC-AI) database)
- Participants
- 49,685 adults · 426 US hospitals
- Exposure
- Hospital-level CKRT utilization quartiles
- Outcome
- All-cause hospital mortality
- Follow-up
- By day 90
Methodological detailsrisk-adjusted
- Risk-adjusted
Main finding
As reported in the abstract
Risk-adjusted all-cause hospital mortality
Each group vs first quartileAdjusted hazard ratio (95% CI)
Third quartile
0.93(0.89–0.98)
Fourth quartile
0.85(0.81–0.89)
- Higher CKRT utilization hospitals (≥ 31.5%) had lower adjusted probability of death vs lower utilization hospitals (< 8%)
- 15%
Observational data: associations, not effects.
Further findings
- Findings consistent in several sensitivity analyses
Original publication
Association of hospital-level continuous kidney replacement therapy use and mortality in critically ill patients with acute kidney injury. Intensive Care Med. Published 30 June 2025. doi:10.
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