Purpose Acute kidney injury (AKI) is a significant cause of morbidity and mortality post cardiac surgery sometimes requiring intermittent hemodialysis (IHD) or continuous veno-venous hemofiltration (CVVH). Previous studies included only procedures utilizing cardiopulmonary bypass (CPB). We reviewed CPB and non-CPB patients who developed AKI and required CVVH versus no CVVH. Materials and Methods 141 patients undergoing adult cardiac surgery developed AKI. 70 required CVVH (group1) and 71 did not (group2). We compared 30 day mortality, renal recovery, respiratory status and late mortality between both groups. Results 73% of patients in group1 required CVVH compared to 51% in group2 (p=0.007). Mortality was 38% versus 25% respectively at 1year (p=0.23) and 54% versus 17% respectively at 30 days (p<0.0001). Renal recovery was found in 47% versus 85%, freedom from ventilator support in 59% versus 83%, and discharge to long term nursing facility (LTNF) in 69% versus 44% respectively. Conclusion Mortality was significantly higher in CVVH group at 30 days but not at 1 year suggesting a long term benefit in those who survive the acute episode. The CVVH group demonstrated a higher rate of discharge to LTNF and lower rates of full renal recovery and freedom from ventilator support at discharge.

Joseph T. McGinn received speakers bureau appointments and honoraria from Medtronic Inc. Other authors have no conflict of interest to disclose.

This study did not receive any funding

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Ethics committee/IRB of Northwell Health Institutional Review Board's (IRB's) Human Research Protection Program (HSRD24-0133), waived ethical approval for this work.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

All data produced in the present work are contained in the manuscript