Despite advances in critical care, mortality rates among critically ill patients with AKI requiring CKRT remains high. This study aims to evaluate clinical characteristics, biochemical markers, and CKRT variables associated with early mortality (<48 hours) and late mortality (>48 hours), and to determine predictors of survival and renal recovery among ICU patients undergoing CKRT in the Philippines.

A retrospective cohort study of 200 patients admitted at ICU of a tertiary hospital in the Philippines, requiring CKRT from 2023-2025. Patients were stratified into early mortality, late mortality, & being discharged alive. Data collected included demographics, co-morbidities, diagnoses, laboratories, and CKRT-related modality, timing, dose, duration, & hemofilter performance.

At least 20.5% of ICU patients with mean APACHE II of 24, were successfully treated and survived past the critical early 48-hour from CKRT. Multivariate regression showed predictors of early mortality: requirement for mech ventilation (p=0.042), history of SLED/HD (p=0.033), no. of inotropes at initiation (p=0.035). Meanwhile, electrolyte abnormality as primary indication, prolonged hemofilter lifespan, history of CV disease offered protective relationship against early death. Univariate analysis showed significant early risks like metabolic acidosis, malignancy, inotrope requirements. Late-phase inpatient mortality was significantly driven by history of hepatic disease, admission to Cardiac ICU, and history of rheumatologic disease. While post-dilution CVVHDF served as significant late protective factor. Late-stage mortality was also characterized by hypoalbuminemia, lower hemoglobin, prolonged PT, elevated INR, and low platelets. Success of CKRT is documented at discharge, where survivors (n=13/19) experienced successful functional recovery, achieving complete dialysis liberation with mean serum creatinine of 1.24±0.86 mg/dL and eGFR of 75.75±35.90 mL/min/1.73m².

CKRT serves as an essential intervention among ICU patients with elevated mean APACHE II score, facilitating a short-term survival rate of 20.5% past the initial 48-hour. Early mortality was driven by profound physiological stressors such as requirement for MV, preceding SLED/HD, concurrent vasopressor burden, metabolic acidosis, malignancy, and higher initiation doses. In contrast, prolonged hemofilter longevity, electrolyte abnormality initialization trigger, and history of CV disease strongly correlated with 48-hour survival.