Lexington, Kentucky, October 1, 2025
News Summary
A recent multicenter study reveals that a significant drop in platelet count during continuous renal replacement therapy (CRRT) is linked to higher hospital mortality among adults with acute kidney injury (AKI). The research analyzed data from over a thousand patients across two tertiary medical centers and identifies key changes in blood counts as vital indicators for predicting mortality risk.
Lexington, Kentucky, and Dallas, Texas
Significant Changes in Platelet and White Blood Cell Counts During CRRT Linked to Higher Hospital Mortality in Adults with AKI
Key finding: A multicenter analysis found that a greater than 1 SD drop in platelet count during CRRT was independently associated with hospital mortality (adjusted odds ratio: 1.82, 95% confidence interval: 1.06, 3.13), while a greater than 1 SD increase in WBC count during CRRT did not significantly affect mortality risk (adjusted odds ratio: 1.41, 95% confidence interval: 0.88, 2.29).
This study examined platelet and white blood cell trends in critically ill adults with acute kidney injury (AKI) who required continuous renal replacement therapy (CRRT). The research analyzed data from 1,413 patients treated at two tertiary medical centers, the University of Kentucky and the University of Texas Southwestern, and covered the years 2011 through 2021. Patients with COVID-19 and those with end-stage renal disease or prior kidney transplant were excluded from the study.
Most important details
The analysis measured percentage changes in platelet and white blood cell (WBC) counts from pre-CRRT to during-CRRT and categorized those changes by standard deviation (SD). Overall mean values in the cohort shifted during CRRT: the mean platelet count decreased by 14% from pre-CRRT to during CRRT, while the mean WBC count increased by 38.2% over the same period. The association between platelet drops and hospital mortality remained significant after adjustment for confounders.
Patient subgroups at increased risk
Four subgroups were identified as having increased mortality risk based on pre-CRRT values and direction of change during therapy:
- Pre-CRRT low platelet count that remained low
- Pre-CRRT normal platelet count that decreased during therapy
- Pre-CRRT elevated WBC count that remained high
- Normal or elevated pre-CRRT WBC count that increased during CRRT
Clinical and demographic patterns
Patients who died during hospitalization tended to be older, had a higher Charlson Comorbidity Index, and required mechanical ventilation more frequently than survivors. The study highlights the high morbidity and mortality rates observed in critically ill adults with AKI who may require extracorporeal organ support.
Study design and oversight
This was a multicenter, retrospective cohort study conducted between 2011 and 2021, involving 1,413 adults with acute kidney injury (AKI) requiring CRRT. Data from two tertiary medical centers, the University of Kentucky and the University of Texas Southwestern, were analyzed. The study was approved by the institutional review boards at both medical centers, and informed consent was waived due to the retrospective nature of the analysis.
Implications for practice and research
The findings suggest that dynamic changes in platelet and WBC counts could be vital indicators for predicting mortality in patients undergoing CRRT. The authors emphasized the importance of monitoring platelet and WBC counts during CRRT in relation to pre-CRRT levels to identify high-risk patients. The study also noted the need for future research to explore the functional aspects of platelets and leukocytes in patients exposed to CRRT.
Frequently Asked Questions
Q: What was the main objective of the study?
A: The study examined the correlation between changes in platelet and white blood cell (WBC) counts from before to during continuous renal replacement therapy (CRRT) with hospital mortality.
Q: What type of study was conducted and how many patients were included?
A: The study was a multicenter, retrospective cohort study conducted between 2011 and 2021, involving 1,413 adults with acute kidney injury (AKI) requiring CRRT.
Q: Which medical centers provided data for the study?
A: Data from two tertiary medical centers, the University of Kentucky and the University of Texas Southwestern, were analyzed.
Q: What specific blood-count changes were linked to mortality?
A: A greater than 1 SD drop in platelet count during CRRT was independently associated with hospital mortality (adjusted odds ratio: 1.82, 95% confidence interval: 1.06, 3.13). A greater than 1 SD increase in WBC count during CRRT did not significantly affect mortality risk (adjusted odds ratio: 1.41, 95% confidence interval: 0.88, 2.29).
Q: What were the mean percentage changes in platelet and WBC counts during CRRT?
A: The mean platelet count in the cohort decreased by 14% from pre-CRRT to during CRRT; there was an increase of 38.2% in the mean WBC count during the same period.
Q: Were any patient groups excluded from the study?
A: Patients with COVID-19 and those with end-stage renal disease or prior kidney transplant were excluded from the study.
Q: What follow-up or further research did the study recommend?
A: Future research is needed to explore the functional aspects of platelets and leukocytes in patients exposed to CRRT.
Key numerical changes and risk measures
| Measure | Value | Notes |
|---|---|---|
| Study period | 2011–2021 | Multicenter, retrospective cohort |
| Number of patients | 1,413 | Adults with AKI requiring CRRT |
| Mean platelet change | -14% | From pre-CRRT to during CRRT |
| Mean WBC change | +38.2% | From pre-CRRT to during CRRT |
| Platelet drop mortality association | Adjusted OR 1.82 | 95% CI: 1.06, 3.13 (greater than 1 SD drop) |
| WBC increase mortality association | Adjusted OR 1.41 | 95% CI: 0.88, 2.29 (greater than 1 SD increase; not significant) |
Deeper Dive: News & Info About This Topic
HERE Resources
Additional Resources
- Renal and Urology News: Hyperlactatemia Ups Death Risk in Patients with CRRT Treated AKI
- BMC Nephrology: Article on CRRT and AKI
- ScienceDirect: Article on Blood Count Changes in CRRT
- Nature: Study on CRRT and Mortality
- Wikipedia: Acute Kidney Injury
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