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Preparing your E-Poster
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E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
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Abstract titles should be brief and reflect the content of the abstract.
Discontinuing continuous kidney replacement therapy (CKRT) remains challenging due to the lack of reliable biomarkers for assessing kidney function recovery. This study proposes a novel assessment protocol during ongoing CKRT and evaluates its predictive utility for both kidney recovery and short-term kidney function.
In this multicenter prospective observational study, 66 patients with complete data were analyzed. The CKRT modality was switched from continuous veno-venous hemodiafiltration (CVVHDF) to continuous veno-venous hemodialysis (CVVHD) to reduce the clearance of larger molecular weight markers such as cystatin C (CysC). Serum creatinine (Cr) and CysC levels were measured at 0, 6, 12, and 24 hours after the mode switch, and their temporal changes and predictive values for kidney recovery were analyzed. Kidney non-recovery was defined as the need to restart kidney replacement therapy (KRT) within seven days after CKRT discontinuation. In patients who achieved recovery, the concordance between estimated glomerular filtration rate (eGFR) values calculated from CysC measured at each time point after the mode switch and the reference eGFR (Cr-CysC) obtained seven days after CKRT discontinuation was evaluated.
Among 66 patients, 32 required KRT restart (non-recovery), and 34 did not (recovery). After the mode switch, serum Cr levels showed no significant differences between groups. However, serum CysC demonstrated progressively improved predictive performance for kidney non-recovery over time. Notably, in predicting kidney non-recovery, the non-indexed eGFR (CysC) measured 12 and 24 hours after the mode switch demonstrated the highest predictive accuracy, with areas under the receiver operating characteristic curve (AUROC) of 0.876 and 0.873, respectively (Figure). In 27 patients who achieved kidney recovery and had available data, the non-indexed eGFR (CysC) at 24 hours after the mode switch showed the highest concordance with eGFR (Cr-CysC) measured seven days post-discontinuation (mean eGFR (Cr-CysC) at 7 days post-discontinuation = 50.1 ± 34.9 ml/min, Table).
Mean ± SD
Pearson coefficient
RMSE
Accuracy (P50)
eGFRCysC (0 hr)
59.2 ± 26.0
0.621
6.57
33.3
eGFRCysC (6 hr)
58.9 ± 25.6
0.569
6.56
40.7
eGFRCysC (12 hr)
60.8 ± 26.0
0.563
6.70
55.6
eGFRCysC (24 hr)
57.8 ± 26.1
0.557
6.47
51.9
Non-indexed eGFRCysC (0 hr)
57.8 ± 25.8
0.685
Non-indexed eGFRCysC (6 hr)
57.5 ± 25.5
0.628
6.45
Non-indexed eGFRCysC (12 hr)
59.7 ± 27.1
0.608
6.61
59.3
Non-indexed eGFRCysC (24 hr)
56.6 ± 26.3
0.623
6.38
63.0
Switching from CVVHDF to CVVHD enables accurate assessment of intrinsic kidney function by evaluating CysC kinetics. The non-indexed eGFR (CysC) measured 24 hours after the mode switch demonstrated strong predictive value for KRT restart and the highest concordance with short-term kidney function after discontinuation. This mode-switch strategy offers a practical, biomarker-based approach to guide CKRT discontinuation and predict post-discontinuation kidney function, thereby potentially improving clinical outcomes.
