---
title: "Risk factors for 90-day RRT failure after cardiac surgery AKI treated with CRRT"
id: "pubmed-42736125"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42736125"
content_type: "clinical_feed_article"
specialty: "Nephrology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42736125/"
doi: "10.3760/cma.j.cn112137-20260204-00393"
published_at: "2026-09-15T00:00:00.000Z"
evidence_level: "English Abstract"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Risk factors for 90-day RRT failure after cardiac surgery AKI treated with CRRT
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42736125
- **Specialty:** [Nephrology](https://medichelpline.com/clinical-feed/nephrology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42736125/)
- **DOI:** [10.3760/cma.j.cn112137-20260204-00393](https://doi.org/10.3760%2Fcma.j.cn112137-20260204-00393)
- **Published At:** 2026-09-15T00:00:00.000Z
- **Evidence Rating:** English Abstract
## Executive GIST (TL;DR)
- This retrospective study analyzed 113 patients who developed postoperative **acute kidney injury (AKI)** and received **continuous renal replacement therapy (CRRT)** after cardiac surgery at a single center between 2018 and 2020. - Patients were followed for 90 days; the primary composite endpoint was dialysis dependence or death at 90 days postoperatively. Participants were categorized into successful RRT (no endpoint) and failed RRT (endpoint occurred) groups. - Baseline cohort: mean age 57.7 ± 12.3 years; 55 males and 58 females; 56 in the successful RRT group and 57 in the failed RRT group. - Compared with the successful group, the failed RRT group had a higher preoperative prevalence of **diabetes mellitus** (29.8% vs 3.6%), lower intraoperative transfused red blood cell volumes and platelet units, higher **serum creatinine at discharge** (230 ± 167 μmol/L vs 129 ± 80 μmol/L), and a larger proportion discharged still **dialysis dependent** (80.7% vs 39.3%). - Multivariable logistic regression identified four independent risk factors for 90-day RRT failure: male sex (OR 2.930), preoperative diabetes mellitus (OR 12.033), higher serum creatinine at discharge (OR 1.006 per μmol/L), and dialysis dependence at discharge (OR 5.147). Reported p-values for these variables were all <0.05. - A risk model combining these four variables produced an area under the ROC curve of 0.850 (95% CI: 0.782–0.918), indicating good discriminative performance for predicting 90-day RRT failure. - The study concludes that **male sex**, **preoperative diabetes**, elevated **serum creatinine at discharge**, and **dialysis dependence at discharge** are associated with higher risk of dialysis dependence or death at 90 days in this population. - All results, including odds ratios, confidence intervals, and ROC parameters, are reported in the article; no additional data or external validation were provided in the source.
## Clinical Analysis & Structured Key Points
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Affiliations Expand ### Affiliations * 1 Department of Nephrology, Fuwai Center China Cardiovascular Hospital, Central China Fuwai Hospital of Zhengzhou University, Zhengzhou 451464, China. * 2 Department of Nephrology, Fuwai Center China Cardiovascular Hospital, Central China Fuwai Hospital of Zhengzhou University, Zhengzhou 451464, China Henan Provincial People's Hospital, Henan Provincial Clinical Research Center for Kidney Disease, Henan Key Laboratory of Nephrology and Immunology, Zhengzhou 451464, China. * PMID: **42736125** * DOI: [ 10.3760/cma.j.cn112137-20260204-00393 ](https://doi.org/10.3760/cma.j.cn112137-20260204-00393) Item in Clipboard # [Analysis of factors influencing prognosis in patients with acute kidney injury receiving continuous renal replacement therapy after cardiac surgery] [Article in Chinese] Z Z You et al. Zhonghua Yi Xue Za Zhi. 2026. Show details Display options Display options Format Abstract PubMed PMID Zhonghua Yi Xue Za Zhi Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Zhonghua+Yi+Xue+Za+Zhi%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Zhonghua+Yi+Xue+Za+Zhi%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42736125/) . 2026 Sep 15;106(34):3630-3636. doi: 10.3760/cma.j.cn112137-20260204-00393. ### Authors [Z Z You](https://pubmed.ncbi.nlm.nih.gov/?term=You+ZZ&cauthor_id=42736125)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42736125/#short-view-affiliation-1 "Department of Nephrology, Fuwai Center China Cardiovascular Hospital, Central China Fuwai Hospital of Zhengzhou University, Zhengzhou 451464, China."), [L J Wang](https://pubmed.ncbi.nlm.nih.gov/?term=Wang+LJ&cauthor_id=42736125)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42736125/#short-view-affiliation-1 "Department of Nephrology, Fuwai Center China Cardiovascular Hospital, Central China Fuwai Hospital of Zhengzhou University, Zhengzhou 451464, China."), [X G Fan](https://pubmed.ncbi.nlm.nih.gov/?term=Fan+XG&cauthor_id=42736125)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42736125/#short-view-affiliation-1 "Department of Nephrology, Fuwai Center China Cardiovascular Hospital, Central China Fuwai Hospital of Zhengzhou University, Zhengzhou 451464, China."), [M Y Zhu](https://pubmed.ncbi.nlm.nih.gov/?term=Zhu+MY&cauthor_id=42736125)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42736125/#short-view-affiliation-1 "Department of Nephrology, Fuwai Center China Cardiovascular Hospital, Central China Fuwai Hospital of Zhengzhou University, Zhengzhou 451464, China."), [Z Zhang](https://pubmed.ncbi.nlm.nih.gov/?term=Zhang+Z&cauthor_id=42736125)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42736125/#short-view-affiliation-1 "Department of Nephrology, Fuwai Center China Cardiovascular Hospital, Central China Fuwai Hospital of Zhengzhou University, Zhengzhou 451464, China."), [Y Gu](https://pubmed.ncbi.nlm.nih.gov/?term=Gu+Y&cauthor_id=42736125)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42736125/#short-view-affiliation-2 "Department of Nephrology, Fuwai Center China Cardiovascular Hospital, Central China Fuwai Hospital of Zhengzhou University, Zhengzhou 451464, China Henan Provincial People's Hospital, Henan Provincial Clinical Research Center for Kidney Disease, Henan Key Laboratory of Nephrology and Immunology, Zhengzhou 451464, China.") ### Affiliations * 1 Department of Nephrology, Fuwai Center China Cardiovascular Hospital, Central China Fuwai Hospital of Zhengzhou University, Zhengzhou 451464, China. * 2 Department of Nephrology, Fuwai Center China Cardiovascular Hospital, Central China Fuwai Hospital of Zhengzhou University, Zhengzhou 451464, China Henan Provincial People's Hospital, Henan Provincial Clinical Research Center for Kidney Disease, Henan Key Laboratory of Nephrology and Immunology, Zhengzhou 451464, China. * PMID: **42736125** * DOI: [ 10.3760/cma.j.cn112137-20260204-00393 ](https://doi.org/10.3760/cma.j.cn112137-20260204-00393) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID ## Abstract in [ English, ](https://pubmed.ncbi.nlm.nih.gov/42736125/#eng-abstract) [ Chinese ](https://pubmed.ncbi.nlm.nih.gov/42736125/#zho-abstract) **Objective:** To analyze the factors influencing prognosis in patients with acute kidney injury (AKI) receiving continuous renal replacement therapy (CRRT) after cardiac surgery. **Methods:** The data of patients who developed postoperative AKI and received CRRT after cardiac surgery at Fuwai Huazhong Cardiovascular Disease Hospital from January 1, 2018 to December 31, 2020, were retrospectively analyzed. All patients were followed up for 90 days after surgery. The primary endpoint was a composite of dialysis dependence or death at 90 days postoperatively. Patients were divided into a successful renal replacement therapy (RRT) group and a failed RRT group according to whether the endpoint occurred. The clinical data were compared between the two groups. A logistic regression model was used to identify independent risk factors for 90-day RRT failure in AKI patients treated with CRRT after surgery, and the area under the receiver operating characteristic (ROC) curve was calculated to evaluate the predictive performance of the model. **Results:** A total of 113 patients aged (57.7±12.3) years were enrolled, including 55 males and 58 females. There were 56 patients in the successful RRT group and 57 in the failed RRT group, respectively. Compared with the successful RRT group, patients in the failed RRT group had a higher preoperative prevalence of diabetes mellitus [29.8% (17/57) vs 3.6% (2/56)], lower intraoperative transfused red blood cell volume [(474±188) ml vs (559±195) ml] and platelet units [(1.2±0.6) U vs (1.5±0.7) U], higher serum creatinine at discharge [(230±167) μmol/L vs (129±80) μmol/L], and a larger proportion of dialysis dependence at discharge [80.7% (46/57) vs 39.3% (22/56)] (all _P_ <0.05). Multivariate logistic regression analysis showed that male sex (_OR_ =2.930, 95%_CI_ : 1.086-7.904, _P_ =0.034), preoperative diabetes mellitus (_OR_ =12.033, 95%_CI_ : 2.136-67.780, _P_ =0.005), serum creatinine at discharge (_OR_ =1.006, 95%_CI_ : 1.002-1.010, _P_ =0.005), and dialysis dependence at discharge (_OR_ =5.147, 95%_CI_ : 1.762-15.036, _P_ =0.003) were independent risk factors for 90-day RRT failure in AKI patients receiving CRRT after cardiac surgery. The risk prediction model constructed with male sex, preoperative diabetes mellitus, serum creatinine at discharge and dialysis dependence at discharge yielded an area under the ROC curve of 0.850 (95%_CI_ : 0.782-0.918, _P_ <0.001). **Conclusion:** Male sex, preoperative diabetes mellitus, and elevated serum creatinine and dialysis dependence at discharge are risk factors for 90-day RRT failure in AKI patients treated with CRRT after cardiac surgery. **目的：** 探讨心脏外科术后急性肾损伤（AKI）行连续性肾脏替代治疗（CRRT）患者预后的影响因素。 **方法：** 回顾性纳入2018年1月1日至2020年12月31日于阜外华中心血管病医院行心脏外科手术，术后发生AKI并行CRRT的患者。术后随访90 d，研究终点为术后90 d是否脱离透析或死亡，按是否发生终点事件分为肾脏替代治疗（RRT）成功组和RRT失败组。比较两组患者临床资料的差异，采用logistic回归模型分析心脏术后AKI并行CRRT患者术后90 d RRT失败的影响因素，用受试者工作特征（ROC）曲线下面积评价模型效能。 **结果：** 共纳入113例患者，男55例，女58例，年龄（57.7±12.3）岁，其中RRT成功组56例，RRT失败组57例。与RRT成功组相比，RRT失败组患者术前合并糖尿病比例较高［29.8%（17/57）比3.6%（2/56）］，术中输注红细胞［（474±188）ml比（559±195）ml］、血小板［（1.2±0.6）U比（1.5±0.7）U］较少，出院时血肌酐［（230±167）μmol/L比（129±80）μmol/L］及未脱离透析的比例［80.7%（46/57）比39.3%（22/56）］较高（均 _P_ <0.05）。多因素logistic回归模型分析结果显示，男性（ _OR_ =2.930，95%_CI_ ：1.086~7.904， _P_ =0.034）、术前合并糖尿病（ _OR_ =12.033，95%_CI_ ：2.136~67.780， _P_ =0.005）、出院时血肌酐较高（ _OR_ =1.006，95%_CI_ ：1.002~1.010， _P_ =0.005）及出院时未脱离透析（ _OR_ =5.147，95%_CI_ ：1.762~15.036， _P_ =0.003）是心脏术后AKI行CRRT患者90 d后RRT失败的危险因素。由以上变量建立的模型ROC曲线下面积为0.850（95%_CI_ ：0.782~0.918， _P_ <0.001）。 **结论：** 男性、术前合并糖尿病、出院时血肌酐较高及出院时未脱离透析为心脏术后AKI行CRRT患者随访90 d后RRT失败的危险因素。. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Conflict of interest statement 所有作者声明不存在利益冲突 ## Similar articles * [ [Risk factors for progression to chronic kidney disease in patients with cardiac valve replacement surgery-associated acute kidney injury]. ](https://pubmed.ncbi.nlm.nih.gov/38901978/) Fan XG, You ZZ, Wang S, Huo S, Zhu MY, Yan L, Gu Y, Shao FM.Fan XG, et al.Zhonghua Yi Xue Za Zhi. 2024 Jun 25;104(24):2222-2228. doi: 10.3760/cma.j.cn112137-20231219-01422.Zhonghua Yi Xue Za Zhi. 2024.PMID: 38901978Chinese. * [ Initial renal replacement therapy (RRT) modality associates with 90-day postdischarge RRT dependence in critically ill AKI survivors. ](https://pubmed.ncbi.nlm.nih.gov/38460295/) Koyner JL, Mackey RH, Echeverri J, Rosenthal NA, Carabuena LA, Bronson-Lowe D, Harenski K, Neyra JA.Koyner JL, et al.J Crit Care. 2024 Aug;82:154764. doi: 10.1016/j.jcrc.2024.154764. Epub 2024 Mar 8.J Crit Care. 2024.PMID: 38460295 * [ [Risk factors analysis of renal replacement therapy after liver transplantation and prognosis effect of initial treatment time]. ](https://pubmed.ncbi.nlm.nih.gov/30541645/) Dong Z, Shi L, Ye L, Xu Z, Zhou L.Dong Z, et al.Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2018 Nov;30(11):1056-1060. doi: 10.3760/cma.j.issn.2095-4352.2018.011.009.Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2018.PMID: 30541645Clinical Trial.Chinese. * [ Mortality prediction in patients with acute kidney injury requiring renal replacement therapy after cardiac surgery. ](https://pubmed.ncbi.nlm.nih.gov/28743566/) Skarupskienė I, Adukauskienė D, Kuzminskienė J, Rimkutė L, Balčiuvienė V, Žiginskienė E, Kuzminskis V, Adukauskaitė A, Pentiokinienė D, Bumblytė IA.Skarupskienė I, et al.Medicina (Kaunas). 2017;53(4):217-223. doi: 10.1016/j.medici.2017.06.003. Epub 2017 Jul 14.Medicina (Kaunas). 2017.PMID: 28743566 * [ Risk model for deaths and renal replacement therapy dependence in patients with acute kidney injury after cardiac surgery. ](https://pubmed.ncbi.nlm.nih.gov/28655154/) Sun S, Ma F, Li Q, Bai M, Li Y, Yu Y, Huang C, Wang H, Ning X.Sun S, et al.Interact Cardiovasc Thorac Surg. 2017 Oct 1;25(4):548-554. doi: 10.1093/icvts/ivx210.Interact Cardiovasc Thorac Surg. 2017.PMID: 28655154 [ See all similar articles ](https://pubmed.ncbi.nlm.nih.gov/?linkname=pubmed_pubmed&from_uid=42736125) ## Publication types * English Abstract Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22English+Abstract%22%5Bpt%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=English+Abstract) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42736125/) ## MeSH terms * Acute Kidney Injury* / therapy Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Acute+Kidney+Injury%2Ftherapy%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Acute+Kidney+Injury) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42736125/) * Cardiac Surgical Procedures Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Cardiac+Surgical+Procedures%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Cardiac+Surgical+Procedures) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42736125/) * Continuous Renal Replacement Therapy* Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Continuous+Renal+Replacement+Therapy%22%5BMAJR%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Continuous+Renal+Replacement+Therapy) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42736125/) * Female Actions * [ Search in PubMed ](https://pubmed.
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