Fluid Balance, Not Ultrafiltration Rate, Drives CRRT Mortality

This large European cohort reframes net ultrafiltration as a tool to reach individualized fluid balance targets rather than a mortality lever in its own right.

continuous renal replacement therapyCRRTnet ultrafiltrationfluid balancefluid overloadacute kidney injurysepsismortalityobservational cohortde-resuscitationcritical care nephrology Critical Care / ICU

Background Information

Fluid balance, not ultrafiltration rate, influences CRRT mortality.

Managing fluid balance in critically ill patients is crucial for improving outcomes during continuous renal replacement therapy (CRRT). No independent association was found between net ultrafiltration (NUF) rate and 28-day mortality; survival was linked to achieving a more negative fluid balance. Clinicians should focus on fluid balance rather than NUF decisions alone to improve patient outcomes in CRRT. Focus on fluid balance to guide NUF decisions in CRRT patients.

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Authors: Monai NC, Pfortmueller CA, Schefold JC, Cioccari L, Faltys M

Citation: Monai NC, Pfortmueller CA, Schefold JC, et al. Net Ultrafiltration Rate and Mortality in Critically Ill Patients: A Multicenter Cohort Study With Analysis of Fluid Balance Changes. Critical care medicine. 2026. doi:10.1097/CCM.0000000000007289

Article Links: PubMed · Journal / DOI

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