In-Hospital Outcomes of Septic Shock Patients Requiring Continuous Renal Replacement Therapy (Crrt): A Nationwide Analysis (2016-2021)

Document Type

Conference Proceeding

Publication Date

5-1-2026

Publication Title

Am J Kidney Dis

Keywords

Urology & Nephrology

Abstract

Septic shock (SS) can be complicated by acute kidney injury requiring CRRT, indicating severe multi-organ failure. Outcomes for this population remain poorly defined. This study evaluated in-hospital outcomes in adults with SS who received CRRT. Using the Nationwide Inpatient Sample (2016–2021), we identified adults ( ≥ 18 years) with SS using ICD-10 codes, excluding ESRD. Patients receiving CRRT were compared with those who did not. The primary outcome was in-hospital mortality; secondary outcomes included mechanical ventilation, tracheostomy, palliative care utilization, length of stay, discharge disposition, and total hospital cost. Multivariable logistic regression adjusted for demographic and clinical factors. Among 736,199 SS hospitalizations, 54,175 (7.4%) received CRRT. CRRT patients were younger (60.9 vs 65.9 years) and less frequently female (39.9% vs 46.1%),with racial differences (White 56.2% vs 63.1%; African American 22.6% vs 15.3%; all P < 0.0001). CRRT use was associated with higher mortality (aOR 3.42; 95% CI 3.28–3.57), higher odds of mechanical ventilation (4.39; 4.17–4.64), tracheostomy (2.08; 1.95–2.23), and palliative care (1.93; 1.85–2.01), all P < 0.0001. CRRT recipients had longer stays (20 vs 14 days), higher costs ($435,668 vs $215,039), and lower home discharge (4.2% vs 12.7%), all P < 0.0001. CRRT in SS is linked to over threefold higher mortality, longer hospitalization, greater complication burden, and markedly greater cost, reflecting advanced multi-organ failure. These findings underscore the need for early renal protection and integrated critical care management strategies.

Volume

87

Issue

5

First Page

S12

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