[Risk factors for unplanned discontinuation of continuous renal replacement therapy in patients admitted to the...

To analyze the risk factors for unplanned discontinuation of continuous renal replacement therapy (CRRT) in intensive care unit (ICU) patients, and to provide a reference for clinical medical staff to identify high-risk patients early and formulate intervention measures.

A cross-sectional study design was adopted. Patients who received CRRT in the Central ICU of the First Affiliated Hospital of Dalian Medical University from March 17 to July 25, 2025 were enrolled. Baseline characteristics, CRRT treatment parameters, treatment-related factors, and medical staff-related factors were collected using the ICU Patient CRRT Unplanned Discontinuation Risk Factor Collection Form. According to whether unplanned discontinuation occurred during CRRT, patients were divided into an unplanned discontinuation group and a normal discontinuation group. Univariate and multivariate logistic regression analyses were performed to identify the risk factors for unplanned CRRT discontinuation.

A total of 386 ICU patients who underwent CRRT were included in this study, among whom 146 (37.8%) experienced unplanned discontinuation and 240 had normal discontinuation. Univariate analysis showed that there were statistically significant differences between the unplanned discontinuation group vs. the normal discontinuation group in gender, Acute Physiology and Chronic Health Evaluation II(APACHE II), Sequential Organ Failure Assessment (SOFA), arterial blood gas pH value, pre-filter pressure, blood flow rate, filtration fraction, transmembrane pressure (TMP), pressure drop, anticoagulant rate, treatment modality, presence of agitation during treatment, presence of hypotension during treatment, use of mechanical ventilation, and use of anticoagulants (all P<0.05). Multivariate logistic regression analysis revealed that agitation during treatment [odds ratio (OR)=2.538, 95% confidence interval (95%CI) was 1.291-4.989], hypotension during treatment (OR=3.958, 95%CI was 1.990-7.871), increased pressure drop (OR=1.062, 95%CI was 1.026-1.099), increased TMP (OR=1.032, 95%CI was 1.009-1.056), increased filtration fraction (OR=1.142, 95%CI was 1.043-1.251), and increased pre-filter pressure (OR=1.057, 95%CI was 1.033-1.081) were independent risk factors for unplanned discontinuation of CRRT in ICU patients, while increased blood flow rate (OR=0.947, 95%CI was 0.927-0.968) was an independent protective factor (all P<0.05).

The incidence of unplanned discontinuation of CRRT among ICU patients was high. Agitation during treatment, hypotension, increased pressure drop, increased transmembrane pressure, increased filtration fraction, and increased pre-filter pressure were independent risk factors for unplanned discontinuation, whereas increased blood flow rate was an independent protective factor. Targeted intervention measures should be developed according to these risk factors.