Comparative Outcomes of Acute Kidney Injury Before And After Extracorporeal Membrane Oxygenation Initiation: A Retrospective Cohort Study

Certificate Output Instructions

For best output, select "Paper Size" as "A4" and "Margin" as "0" or "None".

To save or print to PDF, please select Print Destination > Save as PDF, enable Background Graphics under "More Settings", then click "Save".

Presented the abstract " "
(Abstract co-author(s): )

Back

E-Poster Presentation

During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.

Preparing your E-Poster

Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.

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.

E-Poster Format Requirements

PDF file
Layout: Portrait (vertical orientation)
One page only (Dim A4: 210 x 297mm or PPT)
E-Poster can be prepared in PowerPoint (one (1) PowerPoint slide) but must be saved and submitted as PDF file.
File Size: Maximum file size is 2 Megabytes (2 MB)
No hyperlinks, animated images, animations, and slide transitions
Language: English
Include your abstract number
E-posters can include QR codes, tables and photos

E-Poster

https://storage.unitedwebnetwork.com/files/1099/01bd94ddd022f6774512facd52b277dd.pdf

Abstract Title *

Comparative Outcomes of Acute Kidney Injury Before And After Extracorporeal Membrane Oxygenation Initiation: A Retrospective Cohort Study

Please follow the instructions below to input your abstract title.

Abstract titles should be brief and reflect the content of the abstract.

The title will not be accepted if it exceeds 25 words.
Type in CAPITAL LETTERS.
Lowercase may be used for abbreviations only, for example, mRNA.

Co-author 1

Thitikarn Jungteerapanich Thitikarnjungteerapanich@gmail.com Thammasat University Hospital Department of Medicine Pathum Thani Thailand *

Co-author 2

Nichaporn Chiracharasporn nichaporn@gmail.com Central Chest Institute of Thailand Central Chest Institute of Thailand Nonthaburi Thailand -

Co-author 3

Chanon Chiarnpattanodom chanon.chiarn@gmail.com Thammasat University Hospital Department of Medicine Pathum Thani Thailand -

Co-author 4

Weerinth Puyati pearweerinth@gmail.com Thammasat University Hospital Department of Medicine Pathum Thani Thailand -

Co-author 5

Peerapat Thanapongsatorn Peerapat.manu@gmail.com Thammasat University Hospital Excellence Center for Critical Care Nephrology Pathum Thani Thailand -

Co-author 6

Co-author 7

Co-author 8

Co-author 9

Co-author 10

Co-author 11

Co-author 12

Co-author 13

Co-author 14

Co-author 15

Introduction

Acute kidney injury (AKI) is frequent among patients supported with extracorporeal membrane oxygenation (ECMO) and is linked to high mortality. Whether AKI occurring before ECMO initiation carries a different prognostic significance than AKI developing after ECMO remains uncertain. We evaluated the incidence, timing, and outcomes of AKI in ECMO-treated patients, comparing AKI before versus after ECMO initiation

Methods

We performed a retrospective cohort study at Thammasat University Hospital and Central Chest Institute of Thailand (January 2020–September 2025). Patients receiving ECMO were categorized into three groups: no AKI, AKI before ECMO, and AKI after ECMO. Demographics, ECMO parameters, and laboratory values at ECMO initiation were recorded. Outcomes included ICU mortality, lengths of stay, need for renal replacement therapy, and acute liver failure. Univariable and multivariable logistic regression identified factors associated with ICU mortality.

Results

Among 172 patients, 9 (5.2%) had no AKI, 81 (47.1%) developed AKI before ECMO, and 82 (47.7%) after ECMO. At ECMO initiation, patients with AKI before ECMO had worse kidney and liver profiles (higher BUN, creatinine, AST/ALT, bilirubin) and lower bicarbonate than the other groups (all p≤0.01). Mortality was lower in patients without AKI than in those with AKI before or after ECMO (44.4% vs 82.7% and 69.5%, p=0.016). Comparing AKI subgroups, AKI before ECMO had higher ICU mortality (82.7% vs 69.5%, p=0.048), more severe AKI (96.2% vs 85.2%, p=0.018), greater RRT use (72.8% vs 52.4%, p=0.007), and more acute liver failure (54.3% vs 34.1%, p=0.01). In univariable analysis, AKI before ECMO increased mortality risk (OR 5.98, 95% CI 1.42–25.13), but this association was not independent after adjustment (OR 0.83, 95% CI 0.06–11.10; p=0.89).

Figure 2: Kaplan Meier Survival by AKI timing

Figure 3: Sankey Diagram of AKI mortality Table 1: Baseline Characteristics

Table 1: Outcomes of AKI before, after ECMO, and no AKI

Figure 4: Complications of AKI-ECMO

Conclusion

AKI was highly prevalent among ECMO-treated patients and was associated with substantially higher mortality. AKI present before ECMO portended more severe kidney injury, greater RRT requirement, and worse outcomes than AKI developing after ECMO, although timing was not an independent predictor after adjustment. These findings highlight the need for early risk stratification and organ support optimization prior to ECMO initiation.

Kewords