What question did this study set out to answer?

This study aims to evaluate the in-hospital outcomes of adults with ARDS who received continuous renal replacement therapy (CRRT).

May 20, 2026

A55-33 In-Hospital Outcomes of Acute Respiratory Distress Syndrome Patients Requiring Continuous Renal Replacement Therapy: A Nationwide Analysis (2016-2021)

Key Points

This study aims to evaluate the in-hospital outcomes of adults with ARDS who received continuous renal replacement therapy (CRRT).
Analyzed hospitalizations from the Nationwide Inpatient Sample (2016-2021) using ICD-10 codes.
Identified adults (≥18 years) with ARDS, excluding end-stage renal disease patients.
Compared outcomes between ARDS patients receiving CRRT and those not receiving CRRT.
CRRT was associated with an adjusted OR of 3.3 for in-hospital mortality (95% CI 3.06-3.55; P<0.0001).
Patients receiving CRRT had longer hospital stays (23 vs 17 days; P<0.0001) and higher total charges ($557,424 vs $295,426; P<0.0001).
CRRT recipients exhibited greater odds of complications, including mechanical ventilation (OR 6.63; 95% CI 5.69-7.73) and sepsis (OR 2.67; 95% CI 2.45-2.91).

Abstract

Abstract Rationale Acute respiratory distress syndrome (ARDS) is a life-threatening condition that can be complicated by acute kidney injury requiring continuous renal replacement therapy (CRRT), reflecting severe multi-organ dysfunction. The outcomes of this subgroup remain poorly characterized. This study evaluated in-hospital outcomes among adults with ARDS who received CRRT. Methods Hospitalizations from the Nationwide Inpatient Sample (2016-2021) were analyzed to identify adults (≥18 years) with ARDS using ICD-10 codes. Patients with end-stage renal disease were excluded. The study group comprised those receiving CRRT; the control group included ARDS patients without CRRT. The primary outcome was in-hospital mortality. Secondary outcomes included mechanical ventilation, vasopressor use, sepsis, tracheostomy, length of stay, discharge disposition, and hospitalization cost. Multivariable logistic regression adjusted for demographic and clinical confounders. Results A total of 485, 035 ARDS hospitalizations were identified, of which 26, 995 (5. 6%) received CRRT. Compared with non-CRRT patients, they were younger (58. 4 vs 60. 6 years, P 0. 0001), less often female (34. 5% vs. 44. 0% female, P 0. 0001), and had a different racial distribution (White 50. 0% vs 58. 0%; African American 21. 0% vs 14. 0%; P 0. 0001). After adjustment for confounders, CRRT use was associated with significantly higher in-hospital mortality (adjusted OR 3. 3; 95% CI 3. 06-3. 55; P 0. 0001) and greater odds of mechanical ventilation (6. 63; 5. 69-7. 73), vasopressor use (2. 23; 2. 10-2. 37), sepsis (2. 67; 2. 45-2. 91), and tracheostomy (1. 66; 1. 53-1. 80), all P 0. 0001. CRRT recipients had longer hospital stays (23 vs 17 days; P 0. 0001), higher total charges (557, 424 vs 295, 426; P 0. 0001), and lower home-discharge rates (2. 7% vs 18. 9%; P 0. 0001). Conclusion CRRT in ARDS is associated with nearly threefold higher mortality, prolonged hospitalization, greater complication burden, and markedly higher cost, reflecting advanced multi-organ failure. These findings underscore the need for early renal protection and integrated critical care management strategies. This abstract is funded by: None

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