SP250 CONTRAST-INDUCED ACUTE KIDNEY INJURY: ARE WE PREVENTING BETTER? Olga Mironova 1 , Olga Perekosova 1 , Georgy Isaev 1 , Alina Ushanova 1 , Maria Kovalyova 1 , Alexander Ermolaev 1 , Victor Fomin 1 1 I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia, Russia INTRODUCTION: Each year the number of percutaneous coronary interventions (PCI) is increasing in patients with coronary artery disease (CAD). But before doing PCI different diagnostical tests almost always requiring contrast media are needed to assess the number of lesions and their size. So the problem of contrast-induced acute kidney injury (CI-AKI) and its prevention in patients with risk factors still remains. As we are getting more experience in this field the purpose of the study was to assess the incidence of CI-AKI in patients with stable CAD after PCI in 2012 and 5 years later – in 2017 in the same center to understand whether the doctors are more aware of the existing problem and are preventing it better or not. METHODS: 1023 patients with stable CAD undergoing PCI aged 18-89 were enrolled in our single-center prospective observational study. 561 patients in 2012 and 462 in 2017 respectively. The information concerning patients’ characteristics, risk factors was collected. CI-AKI was defined as an increase of 25% or more, or an absolute increase of 0,5 mg/dl or more in serum creatinine from baseline value, at 48-72 hours following the exposure to CM. We assessed the 5-year prognosis for the first group and 1-year prognosis for the second one respectively via phone calls. RESULTS: The prevalence of CI-AKI in 2012 was 104 cases (18,5%) 69% being male patients, in 2017 the number of cases of CI-AKI was 25 (5,4%) with 52% of male patients suffering from the condition. 79,8% of patients who developed CI-AKI in 2012 were overweight or obese. 92% patients with CI-AKI had BMI higher than normal in 2017 respectively. The number of people suffering from diabetes mellitus and CI-AKI increased from 23% to 32 % in 2017. There were 3 deaths in the group of 5-year prognosis of patients with CI-AKI – 2 cardiovascular deaths and 1 due to a non-cardiac reason. No patients died during the follow-up period for 1 year in the second group. No one developed end stage renal disease (ESRD) in both groups. The main strategy of prevention was rehydration with half-normal saline 1,0 ml/kg/ min for patients without heart failure and 0,5 ml/kg/min in patients with heart failure before and after the procedure. The level of creatinine and eGFR (CKD-EPI) were assessed in 24 and 48 hours after the procedure. Nephrotoxic drugs (for example, metformin) were withdrawn prior to the contrast media exposure. CONCLUSIONS: The number of patients developing CI-AKI after contrast media exposure and PCI significantly fell from 2012 till 2017 in. The doctors’ education and rising awareness are crucial for prevention of the condition. As it is quite easy to prevent CI-AKI but must be done in time and in the right patient. The volume expansion can be done in patients with heart failure in proper way safely. SP251 SUSTAINED LOW EFFICIENCY DIALYSIS IN CRITICALLY ILL PATIENTS. A SINGLE CENTER EXPERIENCE Yasser Abdelhamid 1 , Ahmed Abdelrahman 1 , Abdelrahman Awad 1 1 Cairo University, Faculty Of Medicine, Kasr Al Ainy, Cairo, Egypt INTRODUCTION: Sustained low efficiency dialysis (SLED) is one of renal replacement therapy modalities in critically ill patients with hemodynamic instability that is increasingly used due to its low cost and comparable efficacy to CRRT. Objective: To study the current status of use of SLED therapy in critically ill patients regarding indications of use, efficiency and outcome in Kasr Al Ainy hospital (Faculty of Medicine hospital- Cairo University–Egypt). METHODS: The study included 100 randomly selected ICU patients with AKI requiring RRT who were subjected to SLED therapy. All patients were subjected to full medical history assesement to detect the cause of ICU admission and cause of AKI ,full clinical examination including MAP and CVP , estimation of serum creatinine ,blood urea ,serum Na ,K ,PH, HCO3 and estimation of urea reduction ratio to detect the efficiency of the session. All of clinical and laboratory data were assesed both pre and post sessions. Complications during the sessions were also recorded. APACHE II score and estimation of mortality rate were assessed pre and post sessions. Clinical and laboratory data post sessions were compared to their levels pre sessions. Mean age of patients was 62.91 + 11.80 y. Patients were 68 males (68%) and 32 females (32%) . Thirty patients (30%) were mechanically ventilated and 51 patients (51%) were depending on vasopressor therapy. Mean hospital stay was 20+ 5 days. All dialysis sessions were done through a double lumen central venous catheter. Dialysate components were Na 140 mEq/dl, K 3 mEq/dl, Ca 1.25mmol/l, Mg 0.5mmol/l, Cl 110.5mmol/l. Blood flow rate was 100-200 ml/ minute and dialysate flow rate was 200- 400 ml/ minute. RESULTS: There were statistical highly significant differences (p < 0.001) between mean blood urea, serum creatinine, serum Na, K ,PH , HCO3 ,MAP ,CVP, APACHE II score and predicted mortality rate post dialysis compared to their levels pre dialysis with highly significant improvement of all of these parameters post dialysis. The most common complications recorded during the sessions were hypotension in 36 patients (36%) that necessitated session termination in 13 patients and arrhythmias in 11 patients (11%). Regarding patients outcome; 62 patients (62%) were discharged and 32 patients (32 %) died in ICU due to causes not related to dialysis. CONCLUSIONS: In our center, SLED therapy for critically ill patients with AKI resulted in improvement of pre treatment clinical and laboratory parameters. Intradialytic hypotension and arrhythmias were the major complications recorded that necessitated session termination in some cases. Patients mortality rate was related to their original disease not to the procedure. SP252 HIGH INCIDENCE OF ACUTE KIDNEY INJURY AND MORTALITY IN PATIENTS HOSPITALIZED FOR INFLUENZA VIRUS INFECTION IN A TERTIARY HOSPITAL Isidro Torregrosa 1 , Ma Solis 1 , Carmen Ramos 1 , Aurora Perez-Ys 1 , Andrea Muijsenberg 1 , Elena Gime ´ nez-Civera 1 , Isabel Juan-Garc  ıa 1 , Patricia Tom as 1 , Maria Jes us Puchades 1 , Miguel Gonz alez 1 , Mar  ıa Ramos 1 , Elisa Perez-Bernat 1 , David Navarro 1 , Jose Luis Gorriz 1 1 Hospital Clinico Universitario Valencia , Valencia, Spain INTRODUCTION: Acute Kidney Injury (AKI) incidence depends on its definition and the population studied. The aim of the study is to analyze the incidence of AKI in a population of patients hospitalized for Influenza infection, the factors implicated in its appearance and the impact of AKI on length of hospitalization and mortality. METHODS: A retrospective study was carried out with all patients hospitalized between December 2, 2017 and March 11, 2018 with a microbiological diagnosis of Influenza virus infection. 119 patients were included (64 men and 55 women, mean age 67614a). AKI and mortality related factors were analysed with logistic regression analysis. RESULTS: The most prevalent comorbidities were: age >68a (49.6% of cases), HBP (57.1%), diabetes (37%), COPD (26.1%) and CKD (16.8%). Charlson Index was >2 in 23.7%. In 62 cases the Influenza was type A (H1N1), in 52 was type B and in 5 cases was both A and B. The main complications at admission were: respiratory failure (75.4%), shock (14.4%) and nosocomial infection (8.5%) ). 40.3% had pneumonia, 24.6% were admitted to the ICU and 17.8% received radiologic contrasts. The average stay was 10613d. 11 patients (9.3%) died and 40 (33.6%) presented with AKI (19 KDIGO1, 9 KDIGO2, 12 KDIGO3). 5 patients required urgent dialysis treatment. In the univariate analysis, the factors associated with the appearance of AKI were male sex (p = 0.033), age> 68a (p = 0.005), hypertension (p <0.001), diabetes (p = 0.036), CKD (p = 0.026) , acute heart failure (p = 0.004), nosocomial infection (p = 0.012), respiratory failure (p = 0.029), shock (p <0.001), admission to the ICU (p <0.001) and need for orotracheal intubation (OTI) (p <0.001). In the multivariate analysis, the independent risk factors associated with the presence of AKI were: age> 68a (HR 5.355; [95% CI: 1.795-15.973], p = 0.003), CKD3b (HR 9,015; [95% CI: 1.111-63.169], p = 0.040), admission to the ICU (HR 8.864, [IC95%: 2.728-28.800], p = 0.000) and CRP (HR 1.006, [IC95%: 1.002-1.010], p = 0.001). Patients who developed AKI had a longer average hospitalization than those who did not (15.9 vs 7.5, p = 0.002). The univariate analysis showed a significant association between mortality and AKI (p <0.001). In the Kaplan-Meier analysis, survival rate 90 days after admission was 45% in patients with AKI. In patients without AKI, survival rate was 98% (p = 0.002, Log rank test). The best model of Logistic regression analysis showed that the presence of AKI KDIGO 2 or 3 (HR 15.552; [IC95%: 2.410-94.006], p = 0.04) and the need for OTI (HR 12.771; [IC95 %: 1,649-98,889], p = 0.015), were independent risk factors for mortality. CONCLUSIONS: The incidence of AKI in this population is very high, and it is associated with a longer hospitalization and higher mortality. SP253 ACUTE KIDNEY INJURY AFTER LIVER RESECTION IN ELDERLY PATIENTS Ivana Dedinska 1 , Ludov  ıt Laca 1 , Alexander Ferko 1 , Juraj Miklu sica 1 ,J an Jan  ık 1 , Petra Sk alov a 1 , Karol Gra n ak 1 , Matej Vnu c ak 1 , Pavel Makovick y 2 , Mari an Mok a n 3 1 University hospial Martin and Jessenius Faculty of Medicine Comenius University, Martin, Slovakia, 2 university hospital Martin, Martin, Slovakia and 3 University Hospital Martin and Jessenius faculty of Medicne Comenus Unversity, Martin, Slovakia INTRODUCTION: Acute kidney injury (AKI) affects approximately 13% of patients undergoing major abdominal surgery, and is a common and important clinical sign of perioperative injury. Convincing evidence suggests that the incidence of AKI is rapidly increasing. This increase can partly be attributed to greater recognition of AKI, better doi:10.1093/ndt/gfz103 | i445 Nephrology Dialysis Transplantation Abstracts Downloaded from https://academic.oup.com/ndt/article-abstract/34/Supplement_1/gfz103.SP251/5515009 by guest on 10 June 2020