Blood purifcation procedures Type of blood purifcation HP (Jafron) 2–24 h VVHF 24–72 h CVVHDF 24–72 h CVVHD 24–72 h HDF online 4–10 h HD intermittent 4–10 h SCUF 24–72 h PEX 2–3 h Total number 10 89 147 43 151 49 1 17 Mean 0,17 1.51 2.49 0.72 2.56 0.83 0.016 0.28 Combined blood purifcation procedures Name of the procedure Quantity of procedures (n = 10) Duration (min/h) HP (HA330II) + CVVHF/CVVHDF 5 >3 (180 min) PS (BS 330) + CVVHF/CVVHDF 5 >3 (180 min) Laboratory data of patients with AKI Laboratory data Initial level (before LVAD implantation) After LVAD implantation After blood purifcation Discharge from the hospital CREA mg/dL 1.46 ± 0.61 2.79 ± 1.3617 2.1 ± 0.51 1.6 ± 0.16 UREA mg/dL 57.16 ± 60.11 108.9 ± 47.1 76.2 ± 31.28 53.85 ± 30.49 GFR 49.7 ± 24.77 33.74 ± 26.05 46.77 ± 26.32 48.06 ± 33.18 К mmol/L 4.1 ± 0.65 5.2 ± 1.14 4.1 ± 0.63 3.92 ± 0.49 Na mmol/L 139.6 ± 3.78 147.6 ± 15.20 137 ± 3.08 38 ± 1.58 MO359 ACUTE RENAL FAILURE IN COVID-19 PATIENTS IN A LATIN AMERICAN HEALTH INSTITUTION Luis Dulcey 1 , Juan Theran 2 , Hernando Gonzalez 3 , Aldahir Quintero 4 , Melissa Aguas 3 and Rafael Parales 2 1 Internal Medicine, Los Andes University, Merida, Venezuela, 2 Medicine, Bucaramanga University, Bucaramanga, Colombia, 3 Medicine, Santander University, Bucaramanga, Colombia and 4 Medicine, Metropolitan University, Bucaramanga, Colombia BACKGROUND AND AIMS: Acute renal failure in hospitalized patients for COVID- 19 occurs in 3%–28% and is a poor prognostic factor. The mechanisms of renal involvement are not completely clarifed. However, it has been evaluated that the presentation of renal failure increases adverse outcomes. METHOD: Prospective observational study of all the cases that were admitted for COVID-19 between January and December 2021. Clinical and analytical data of kidney complications in patients with COVID-19 were collected. RESULTS: A total of 306 patients with a mean age of 70.2 years, 75.1% men and with previous chronic kidney disease in 29.7% were analyzed. A total of 50.8% had severe pneumonia or acute respiratory distress syndrome and 22.9% required admission to the ICU. Proteinuria was registered in 77.6% and hematuria in 67.6%. A total of 20.9% of the patients required renal replacement therapy. Renal failure was of prerenal etiology in 59.2%, acute tubular necrosis in the context of sepsis in 23.5%, glomerular in 8.1% and due to tubular toxicity in 9.2%. The median stay was 15 days, and 31.7% died. Patients who developed kidney failure during admission had higher C-reactive protein, LDH, and D-dimer values, more severe lung involvement, more need for ICU admission, and greater need for renal replacement therapy. CONCLUSION: Hypovolemia and dehydration are common causes of acute kidney injury in COVID-19 patients. Those who develop renal complications have a worse pulmonary, renal and systemic prognosis profle. We point out that monitoring an individualized management of blood volume can be decisive in preventing worse outcomes. Table 1. Study variables and characteristics obtained from the data Age Mean age of 70.2 years Gender 75.1% men Previous chronic kidney disease 29.7% Renal replacement therapy 20.9% ICU median stay 15 days Mortality 31.7% MO360 USING ROUTINELY COLLECTED DATA TO DEFINE THE OPTIMAL TIMING TO INITIATE RENAL REPLACEMENT THERAPY IN AKI PATIENTS Pawel Morzywolek 1,2 , Johan Steen 1,2,3 , Stijn Vansteelandt 1,2,4 , Johan Decruyenaere 2,5 and Wim Van Biesen 2,3 1 Department of Applied Mathematics, Ghent University, Computer Science and Statistics, Ghent, Belgium, 2 Centre for Justifiable Digital Healthcare, Ghent University Hospital, Ghent, Belgium, 3 Renal Department, Ghent University Hospital, Ghent, Belgium, 4 Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK and 5 Department of Intensive Care Medicine, Ghent University Hospital, Ghent, Belgium BACKGROUND AND AIMS: The optimal moment to start renal replacement therapy (RRT) in patients with acute kidney injury (AKI) in the intensive care unit (ICU) remains a challenging problem. Evidence is lacking that, in absence of absolute criteria for pH or serum potassium, timing of RRT initiation (early versus delayed) afects survival. The optimal cut-ofs for these absolute criteria are however poorly defned. We used routinely collected observational data from tertiary ICUs to investigate whether applying pre-specifed dynamic strategies for RRT initiation based on time-updated levels of serum potassium and pH, next to persisting oliguria, could further minimize 30-day ICU mortality in patients with stage 2 KDIGO-AKI. METHOD: Based on cut-of values applied in large key RCTs on this topic, we investigated diferent pH thresholds ranging from 7.0 to 7.2 and serum potassium thresholds ranging from 5.5 to 6.5 mmol/L to identify the treatment strategy resulting in the lowest 30-day ICU mortality. Patients were followed from the time when one of the stage 2 KDIGO-AKI criteria was satisfed for the frst time (considered as day 0) until ICU death, discharge or day 30, whichever occurred frst. We evaluated decision rules in a hypothetical setting where a decision about RRT initiation is made every 24 h starting from day 0 based on the information available up to that point. If the treatment decision based on the considered strategy did not coincide with the observed treatment, the patient was censored for this regime from this time-point onward. We applied inverse probability of censoring (IPC) weighting to deal with potential selection bias due to this artifcial censoring. We calculated the cumulative ICU mortality under each strategy using the IPC-weighted Aalen–Johansen estimator. We considered the best RRT initiation regime to be the one providing the lowest 30-day ICU mortality. We moreover estimated the number of patients actually initiated on RRT under the diferent regimes. RESULTS: Of the 13403 available, potentially eligible ICU admissions between 1 January 2013 and 31 December 2017 (62.2% male, 60.8 ± 16.8 years of age, SOFA 7.0 ± 4.1), 4769 individual patients (66.4% male, 63.3 ± 15.6 years of age, SOFA 8.4 ± 4.3) met our in and exclusion criteria. Figure 1 presents the cumulative ICU mortality since day 0 for the treatment strategies: ‘Initiate RRT if creatinine stage 2 KDIGO-AKI condition has been met and at least one of the events occurred: pH < x,K > 6.0 mmol/L or oliguric stage 3 KDIGO-AKI condition has been met’ (left panel) or based only on pH measurement (so irrespective of serum potassium): ‘Initiate RRT if creatinine stage 2 KDIGO-AKI condition has been met and at least one of the events occurred: pH < x or oliguric stage 3 KDIGO-AKI condition has been met’ (right panel). The black line (obs) Abstract i263 Downloaded from https://academic.oup.com/ndt/article/37/Supplement_3/gfac135.014/6577471 by guest on 02 October 2022