title: Determinants of outcome in non-septic critically ill patients with acute kidney injury on continuous venovenous hemofiltration.
abstract: OBJECTIVE
  In view of ongoing controversy, we wished to study whether patient characteristics and/or continuous venovenous hemofiltration (CVVH) characteristics contribute to the outcome of non-septic critically ill patients with acute kidney injury (AKI).
  
  
  METHODS
  We retrospectively studied 102 consecutive patients in the intensive care unit (ICU) with non-septic AKI needing CVVH. Patient and CVVH characteristics were evaluated. Primary outcome was mortality up to day 28 after CVVH initiation.
  
  
  RESULTS
  Forty-four patients (43%) died during the 28-day period after the start of CVVH. In univariate analyses, non-survivors had more often a cardiovascular reason for ICU admission, greater disease acuity/severity and organ failure, lower initial creatinine levels, less use of heparin and more use of bicarbonate-based substitution fluid. The latter two can be attributed to high lactate levels and bleeding tendency in non-survivors necessitating withholding lactate-buffered fluid and heparin, respectively, according to our clinical protocol. In multivariate analyses, mortality was predicted by disease severity, use of bicarbonate-based fluids and lack of heparin, while initial creatinine and CVVH dose did not contribute.
  
  
  CONCLUSIONS
  The outcome of non-septic AKI in need of CVVH is more likely to be determined by underlying or concurrent, acute and severe disease rather than by CVVH characteristics, including timing and dose.
authors.affiliation: Department of Intensive Care, Free University Medical Center, Amsterdam, The Netherlands.
authors.forename: Mark V
authors.initials: MV
authors.lastname: Koning
authors.forename: Asselina A
authors.initials: AA
authors.lastname: Roest
authors.forename: Marc G
authors.initials: MG
authors.lastname: Vervloet
authors.forename: A B Johan
authors.initials: AB
authors.lastname: Groeneveld
authors.forename: Shaikh A
authors.initials: SA
authors.lastname: Nurmohamed