Using Estimated Plasma Volume Status To Predict The Need For Dialysis In Patients With Acute Kidney Injury

Estimated plasma volume status (ePVS), derived from routine hematological parameters, has recently emerged as a non-invasive marker of volume overload in critically ill patients. However, its prognostic value in acute kidney injury (AKI) patients presenting to the emergency department remains unclear. This study was conducted to evaluate the relationship between ePVS and dialysis requirement in patients diagnosed with AKI in the emergency department. In this retrospective cohort study, 306 adult patients diagnosed with AKI according to KDIGO 2012 criteria between January 2020 and December 2024 were included. ePVS was calculated using the Duarte formula. Patients were stratified into dialysis and non-dialysis groups. After adjusting for clinical and laboratory covariates, multivariable logistic regression analyses were performed to assess the independent relationship between ePVS and dialysis requirement and 30-day mortality. Model discrimination was evaluated using the ROC curve. ePVS values were significantly higher in the dialysis group compared to the non-dialysis group (p < 0.01). ePVS demonstrated moderate discriminative ability for predicting dialysis requirement (AUC = 0.66). An optimal cut-off value of ePVS > 5.37 mL/g for predicting dialysis requirement was identified in this cohort. ePVS may represent a practical and accessible tool to estimate volume status assist in predicting dialysis requirement in AKI patients. To our knowledge, this is the first study to evaluate the prognostic significance of ePVS in AKI patients within the emergency department setting. Further prospective, multicenter studies are warranted to validate these findings.