Net Ultrafiltration Rate and Mortality in Critically Ill Patients: A Multicenter Cohort Study With Analysis of Fluid Balance Changes
Authors' conclusion
In this two-center cohort of CRRT patients, NUF rate was not independently associated with mortality. Instead, the key determinant of outcome was fluid balance change.
Study context
- Population
- Adult critically ill patients receiving continuous renal replacement therapy (CRRT) for at least 24 hours in two European mixed medical-surgical ICUs (Bern, Switzerland; Amsterdam, the Netherlands)6,914 days of CRRT
- Participants
- 973 patients
- Exposure
- Net ultrafiltration (NUF) rate categories and fluid balance change categories
- Outcome
- 28-day mortality by NUF rate
Methodological detailsmulticentre, observational, mediation analysis, random forest modeling
- Multicentre
- Observational
- Mediation analysis
- Random forest modeling
Main finding
As reported in the abstract
- No independent association between NUF rate and 28-day mortality after accounting for fluid balance
- Apparent survival advantage with higher NUF rates largely mediated through a more negative fluid balance, not a direct effect of NUF rate
- Multivariable regression, random forest modeling, mediation analysis
Observational data: associations, not effects.
Further findings
Fluid balance change (negative < −1.5 L/day, moderate negative −1.5 to −0.5 L/day, neutral −0.5 to 0.5 L/day, positive > 0.5 L/day) and outcomes
- More positive fluid balance changes linked to adverse clinical outcomes including 28-day mortality
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Net Ultrafiltration Rate and Mortality in Critically Ill Patients: A Multicenter Cohort Study With Analysis of Fluid Balance Changes. Crit Care Med. Published 12 August 2026. doi:10.
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