Key result
Vasopressor use post-renal replacement therapy initiation was associated with higher in-hospital mortality in patients receiving CRRT (aHR 1.69) or IHD (aHR 1.72).
Why the study?
Among critically ill patients with AKI requiring RRT, whether vasopressor use is associated with clinical outcomes remained unclear.
Does vasopressor use following renal replacement therapy initiation increase in-hospital mortality in critically ill adults with acute kidney injury?
Observational (n=20,882)
Yes
Does vasopressor use following renal replacement therapy initiation increase in-hospital mortality in critically ill adults with acute kidney injury?
Hazard Ratio: 1.69 (95% CI 1.55–1.85)
Vasopressor use following RRT initiation in critically ill patients with AKI is independently and incrementally associated with higher in-hospital mortality.
Suggests vasopressor requirements following renal replacement therapy initiation may flag higher mortality risk; leaves open.
Among critically ill patients with acute kidney injury (AKI) requiring renal replacement therapy (RRT) whether vasopressor use is associated with outcomes is unclear. We examined the association of vasopressor use following RRT initiation with in-hospital mortality in critically ill adults with AKI requiring different modalities of RRT. This observational study was conducted using the Premier Inc. (PINC) AI Healthcare Database of patients (n = 20,882) in U.S. hospitals with AKI requiring continuous RRT (n = 7660) and intermittent hemodialysis ([IHD], n = 13,222) with discharge from January 1, 2018, to June 30, 2021. Data on vasopressor use 3 days before and 3 days after RRT initiation were extracted. Exposure to vasopressors post-RRT initiation was significantly associated with risk-adjusted in-hospital mortality among patients treated with CRRT (risk-adjusted hazard ratio [aHR], 1.69 95 %CI: 1.55-1.85) and IHD (aHR, 1.72, 95 %CI: 1.61-1.84). There was an incremental risk of death associated with the number of vasopressors. Among CRRT patients, the risk of death were: 1 vasopressor (aHR, 1.50; 95 % CI: 1.36-1.65), 2 vasopressors (aHR, 1.94; 95 % CI: 1.76-2.14), and 3 vasopressors (aHR, 2.06; 95 % CI: 1.72-2.46). Similarly, for IHD patients, the aHRs were: 1 vasopressor (aHR, 1.57; 95 % CI: 1.47-1.68), 2 vasopressors (aHR, 2.20; 95 % CI: 2.02-2.40), and 3 vasopressors (aHR, 2.32; 95 % CI: 1.82-2.96). In summary, vasopressor use during the 3 days post-RRT initiation was independently and incrementally associated with higher in-hospital mortality in patients receiving either CRRT or IHD as the first modality.
No takes yet. Share an insight, caveat, or question.
Neyra et al. (2025) conducted an observational in Acute kidney injury requiring renal replacement therapy (n=20,882). Vasopressor use vs. No vasopressor use was evaluated on In-hospital mortality (aHR 1.69, 95% CI 1.55-1.85). Vasopressor use post-renal replacement therapy initiation was associated with higher in-hospital mortality in patients receiving CRRT (aHR 1.69) or IHD (aHR 1.72).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: