Effect modification by chronic kidney disease on renal outcomes in septic shock patients undergoing high-MAP targeting: a secondary analysis of the OPTPRESS trial
Authors' conclusion
Documented history of CKD may modify the renal response to high-MAP targeting in elderly patients with septic shock. High-MAP targets were associated with fewer RRT-FD in patients without CKD.
Study context
- Population
- Patients aged ≥ 65 years with septic shock (70 with chronic kidney disease (CKD), 361 without)complete case analysis
- Participants
- 431 patients
- Comparison
- High-MAP vs standard-MAP targets, by CKD status
- Primary endpoint
- RRT-free days (RRT-FD)
- Follow-up
- 28 days
Methodological detailspost hoc, multicentre, subgroup analysis by CKD status, inverse probability of treatment weighting (IPTW) and multiple imputation sensitivity analysis
- Post hoc
- Multicentre
- Subgroup analysis by CKD status
- IPTW and multiple imputation sensitivity analysis
Primary result
As reported in the abstract
RRT-FD by CKD status (subgroup)
Adjusted β
- 3.5 days
95% CI - 5.94 to - 1.11
without CKD (n=361)
Adjusted β
+ 2.0 days
95% CI - 4.34 to + 8.35
with CKD (n=70); no significant association
Secondary outcomes
Major adverse kidney events (MAKE) at hospital discharge, by CKD status (subgroup)
- Direction of effect consistent with renal replacement therapy-free days (RRT-FD); not statistically significant in patients without CKD
Sensitivity analysis (IPTW, multiple imputation)
- Directionally consistent findings
Original publication
Effect modification by chronic kidney disease on renal outcomes in septic shock patients undergoing high-MAP targeting: a secondary analysis of the OPTPRESS trial. J Intensive Care. Published 18 April 2026. doi:10.
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