What question did this study set out to answer?

To characterize continuous renal replacement therapy practice patterns—including dialysis dose, modality, and anticoagulation—and evaluate predictors of in-hospital mortality in critically ill patients with cirrhosis or acute-on-chronic liver failure.

September 18, 2026Critical Care Medicine

Epidemiology of Critically Ill Patients With Cirrhosis Undergoing Continuous Renal Replacement Therapy: A Contemporaneous Parallel Analysis of the HRS-HARMONY and CRRTnet Registries

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Authors

CKConstantine Karvellas JLJoshua Lambert TOTianqi Ouyang

Discussion

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Overview

Parallel cohort study observes high mortality linked to higher dialysis dose in critically ill cirrhosis, highlighting potential risks of intensive renal replacement therapy.

Key Points

To characterize continuous renal replacement therapy practice patterns—including dialysis dose, modality, and anticoagulation—and evaluate predictors of in-hospital mortality in critically ill patients with cirrhosis or acute-on-chronic liver failure.
Conducted a parallel cohort study using contemporaneous data from two multicenter registry databases in the United States and Canada: HRS-HARMONY (n = 245) and CRRTnet (n = 206).
Assessed CRRT process factors, liver failure severity scores, and cause of acute kidney injury relative to in-hospital mortality using multivariable regression.
Overall survival to hospital discharge was 34% in the HARMONY cohort and 30% in the CRRTnet cohort.
Higher chronic liver failure-C ACLF scores were independently associated with increased in-hospital mortality in HARMONY (hazard ratio, 1.03; 95% CI, 1.01–1.05; p < 0.001).
An initial prescribed continuous renal replacement therapy dose exceeding 30 mL/kg/hr independently predicted greater in-hospital mortality in CRRTnet (odds ratio, 2.69; 95% CI, 1.3–5.64; p = 0.01).

Cite This Study

Karvellas et al. (2026) studied this question.

synapsesocial.com/papers/6aad0bb6de0393d728b8a150 https://doi.org/10.1097/ccm.0000000000007363

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September 18, 2026Critical Care Medicine

Epidemiology of Critically Ill Patients With Cirrhosis Undergoing Continuous Renal Replacement Therapy: A Contemporaneous Parallel Analysis of the HRS-HARMONY and CRRTnet Registries

View Full Paper

Ask AI

Bookmark

Authors

CKConstantine Karvellas JLJoshua Lambert TOTianqi Ouyang

Discussion

Member takes

Overview

Parallel cohort study observes high mortality linked to higher dialysis dose in critically ill cirrhosis, highlighting potential risks of intensive renal replacement therapy.

Key Points

To characterize continuous renal replacement therapy practice patterns—including dialysis dose, modality, and anticoagulation—and evaluate predictors of in-hospital mortality in critically ill patients with cirrhosis or acute-on-chronic liver failure.
Conducted a parallel cohort study using contemporaneous data from two multicenter registry databases in the United States and Canada: HRS-HARMONY (n = 245) and CRRTnet (n = 206).
Assessed CRRT process factors, liver failure severity scores, and cause of acute kidney injury relative to in-hospital mortality using multivariable regression.
Overall survival to hospital discharge was 34% in the HARMONY cohort and 30% in the CRRTnet cohort.
Higher chronic liver failure-C ACLF scores were independently associated with increased in-hospital mortality in HARMONY (hazard ratio, 1.03; 95% CI, 1.01–1.05; p < 0.001).
An initial prescribed continuous renal replacement therapy dose exceeding 30 mL/kg/hr independently predicted greater in-hospital mortality in CRRTnet (odds ratio, 2.69; 95% CI, 1.3–5.64; p = 0.01).

Cite This Study

Karvellas et al. (2026) studied this question.

synapsesocial.com/papers/6aad0bb6de0393d728b8a150 https://doi.org/10.1097/ccm.0000000000007363

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