MO391RISK FACTORS OF ACUTE KIDNEY INJURY IN SEVERE ACUTE RESPIRATORY ILLNESS DURING CORONAVIRUS DISEASE 2019 PANDEMIC

Abstract Background and Aims Acute Kidney Injury (AKI) is associated with poor outcome in severe acute respiratory illness (SARI) during Coronavirus Disease 2019 (COVID 19) pandemic. This study aim at detetction of risk factors for AKI among patients admitted for SARI at our Center for COVID 19 screening. Method Restrospective study by reviewing admission notes from March 2020 until December 2020 at our district center. Patient aged more than 18 year old who admitted for SARI as defined by World Health Organisation and AKI as defined by Kidney Disease Improving Global Outcome (KDIGO) guideline were included. Chronic kidney disease and End stage Renal Failure as defined by KDIGO were excluded. Results A total 230 ( 56%) patients out of 410 patients with SARI had AKI during hospitalisation. The mean age was 72 years old (SD 13.8), 130 (56.5%) were male and 100 ( 43.5%) were female. SARI patients with AKI took mean 5 days ( SD 0.9) to be admitted at our center from the first day of illness. The mean body mass index (BMI) was 27.2 kg/m2 . The mean arterial pressure was 52.1 ( SD 3.7) mmhg upon admission. The mean neutrophils lymphocytes ratio ( NLR ) was 22.4 (SD 2.4). The independant Risk factors for AKI in SARI are Male gender ( OR 0.95; 95% CI 0.35-2.6), smoking ( OR 0.72 ;95% CI 0.23- 2.3), ischaemic heart disease (OR 0.48; 95% CI 0.06-3.8), diabetes mellitus ( OR 1.15; 95% CI 0.39-3.38) and hypertension ( OR 1.58; 95% CI 0.58-4.25). Conclusion Non modifiable risk factors for AKI in SARI include male gender and advance age. The modifiable risk factors for AKI in SARI are over weight, smoking, ischemic heart disease, diabetes mellitus and hypertension. NLR play a role in predicting AKI among SARI patients. Delay hospitalisation and hypoperfusion predispose to AKI in SARI. Early recognition of risk factors is crucial in preventing deterioration of kidney function in SARI patients during the inital screening for COVID 19 infection.

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Global risk factors of contrast-induced acute kidney injury: systematic review and meta-analysis

European Heart Journal ◽

10.1093/ehjci/ehaa946.2448 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

L Liu ◽

Y Liu ◽

S Chen ◽

E.Y.M Chung ◽

L Lei ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Acute Kidney Injury ◽

Meta Analysis ◽

Kidney Injury ◽

Left Ventricular ◽

Public Institution ◽

Left Ventricular Ejection ◽

Modifiable Risk Factors ◽

Funding Source

Abstract Background Administration of iodinated contrast is common but may be associated with contrast-induced acute kidney injury (CI-AKI), particularly in at-risk patients. There is no recent systematic review of potentially modifiable risk factors. Methods We searched MEDLINE, Embase and the Cochrane Database of Systematic Reviews (to 30 th June 2019) for observational studies assessing risk factors associated with CI-AKI. Twelve potentially modifiable risk factors were finally included in this thematic review and meta-analysis. Random or fixed meta-analysis was performed to derive the adjusted odds ratio (aOR), and the population attributable risk (PAR) was calculated for each risk factor globally and by region. Findings We included 157 studies (2,297,863 participants). The global incidence of CI-AKI was 5.4%. The potentially modifiable risk factors included high contrast volume (PAR 33%), eight cardiovascular risk factors (diuretic use, multivessel coronary artery disease, acute coronary syndrome, hypertension, hypotension, heart failure, reduced left ventricular ejection fraction and intra-aortic balloon pump use) (combined PAR 76.2%) and three noncardiovascular risk factors (renal dysfunction, diabetes mellitus and anaemia) (combined PAR 47.4%) with geographical differences. Bubble chart of the 12 risk factors Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): National Science Foundation of China

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Identification of modifiable risk factors for acute kidney injury after coronary artery bypass graft surgery in an Asian population

Journal of Thoracic and Cardiovascular Surgery ◽

10.1016/j.jtcvs.2013.09.040 ◽

2014 ◽

Vol 147 (4) ◽

pp. 1356-1361 ◽

Cited By ~ 42

Author(s):

Roderica Rui Ge Ng ◽

Sophia Tsong Huey Chew ◽

Weiling Liu ◽

Liang Shen ◽

Lian Kah Ti

Keyword(s):

Risk Factors ◽

Acute Kidney Injury ◽

Coronary Artery ◽

Coronary Artery Bypass Graft ◽

Artery Bypass ◽

Bypass Graft ◽

Kidney Injury ◽

Asian Population ◽

Modifiable Risk Factors ◽

Artery Bypass Graft

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GW28-e0997 Risk factors of contrast-induced acute kidney injury in patients with diabetes mellitus undergoing emergency percutaneous coronary intervention

Journal of the American College of Cardiology ◽

10.1016/j.jacc.2017.07.655 ◽

2017 ◽

Vol 70 (16) ◽

pp. C178

Author(s):

Chao Shi ◽

Yujie Zhou

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Acute Kidney Injury ◽

Percutaneous Coronary Intervention ◽

Kidney Injury ◽

Coronary Intervention ◽

Percutaneous Coronary ◽

Patients With Diabetes ◽

Emergency Percutaneous Coronary Intervention

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Modifiable risk factors of acute kidney injury after liver transplantation: a systematic review and meta-analysis

BMC Nephrology ◽

10.1186/s12882-021-02360-8 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Jian Zhou ◽

Xueying Zhang ◽

Lin Lyu ◽

Xiaojun Ma ◽

Guishen Miao ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Liver Transplantation ◽

Acute Kidney Injury ◽

Protective Factor ◽

Calcineurin Inhibitor ◽

Meta Analysis ◽

Random Effect Model ◽

Kidney Injury ◽

Modifiable Risk Factors

Abstract Background Acute kidney injury (AKI) is a common and critical complication of liver transplantation (LT), which is associated with increased morbidity, mortality and health care cost. We aimed to identify modifiable risk factors of AKI after LT. Methods A literature search of Pubmed, EMBASE and Cochrane Databases was performed to identify studies investigating risk factors of AKI after LT. The Newcastle-Ottawa Scale was used to rate study quality. Effect size and 95% confidence interval were pooled using a random-effect model with inverse-variance method. Results Sixty-seven articles with 28,844 patients were included in the meta-analysis. Seventeen modifiable risk factors were found, including overweight, preoperative use of diuretic, preoperative anemia, donation after cardiac death organ, donor BMI ≥ 30 kg/m2, ABO-incompatible LT, low graft to recipient body weight ratio, intraoperative hypotension, major bleeding, intraoperative use of vasopressor, large RBC transfusion, postreperfusion syndrome, postoperative use of vasopressors, overexposure to calcineurin inhibitor, calcineurin inhibitor without mycophenolate mofetil, graft dysfunction and infection. A total of 38 articles were included in the systematic review, in which 8 modifiable risk factors and 1 protective factor were additionally associated in single studies with the incidence of AKI after LT. Conclusions Effective interventions based on identified modifiable risk factors in the perioperative management and graft allocation and preservation may be promising to reduce the incidence of AKI after LT. Trial registration The protocol for this systematic review is registered with PROSPERO (No. CRD42020166918).

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Development and Validation of an Acute Kidney Injury Risk Index for Patients Undergoing General Surgery

Anesthesiology ◽

10.1097/aln.0b013e3181979440 ◽

2009 ◽

Vol 110 (3) ◽

pp. 505-515 ◽

Cited By ~ 310

Author(s):

Sachin Kheterpal ◽

Kevin K. Tremper ◽

Michael Heung ◽

Andrew L. Rosenberg ◽

Michael Englesbe ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Acute Kidney Injury ◽

Renal Insufficiency ◽

General Surgery ◽

Injury Risk ◽

Risk Index ◽

Kidney Injury ◽

Improvement Program ◽

Data Set

Background The authors sought to identify the incidence, risk factors, and mortality impact of acute kidney injury (AKI) after general surgery using a large and representative national clinical data set. Methods The 2005-2006 American College of Surgeons-National Surgical Quality Improvement Program participant use data file is a compilation of outcome data from general surgery procedures performed in 121 US medical centers. The primary outcome was AKI within 30 days, defined as an increase in serum creatinine of at least 2 mg/dl or acute renal failure necessitating dialysis. A variety of patient comorbidities and operative characteristics were evaluated as possible predictors of AKI. A logistic regression full model fit was used to create an AKI model and risk index. Thirty-day mortality among patients with and without AKI was compared. Results Of 152,244 operations reviewed, 75,952 met the inclusion criteria, and 762 (1.0%) were complicated by AKI. The authors identified 11 independent preoperative predictors: age 56 yr or older, male sex, emergency surgery, intraperitoneal surgery, diabetes mellitus necessitating oral therapy, diabetes mellitus necessitating insulin therapy, active congestive heart failure, ascites, hypertension, mild preoperative renal insufficiency, and moderate preoperative renal insufficiency. The c statistic for a simplified risk index was 0.80 in the derivation and validation cohorts. Class V patients (six or more risk factors) had a 9% incidence of AKI. Overall, patients experiencing AKI had an eightfold increase in 30-day mortality. Conclusions Approximately 1% of general surgery cases are complicated by AKI. The authors have developed a robust risk index based on easily identified preoperative comorbidities and patient characteristics.

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Risk Factors for Influenza-Associated Severe Acute Respiratory Illness Hospitalization in South Africa, 2012–2015

Open Forum Infectious Diseases ◽

10.1093/ofid/ofw262 ◽

2017 ◽

Vol 4 (1) ◽

Cited By ~ 27

Author(s):

Stefano Tempia ◽

Sibongile Walaza ◽

Jocelyn Moyes ◽

Adam L. Cohen ◽

Claire von Mollendorf ◽

...

Keyword(s):

Risk Factors ◽

South Africa ◽

Heart Diseases ◽

Multivariable Analysis ◽

Respiratory Illness ◽

Acute Respiratory Illness ◽

Medical Conditions ◽

Chronic Lung Diseases ◽

Increased Risk ◽

Severe Acute Respiratory Illness

Abstract Background Data on risk factors for influenza-associated hospitalizations in low- and middle-income countries are limited. Methods We conducted active syndromic surveillance for hospitalized severe acute respiratory illness (SARI) and outpatient influenza-like illness (ILI) in 2 provinces of South Africa during 2012–2015. We compared the characteristics of influenza-positive patients with SARI to those with ILI to identify factors associated with severe disease requiring hospitalization, using unconditional logistic regression. Results During the study period, influenza virus was detected in 5.9% (110 of 1861) and 15.8% (577 of 3652) of SARI and ILI cases, respectively. On multivariable analysis factors significantly associated with increased risk of influenza-associated SARI hospitalization were as follows: younger and older age (<6 months [adjusted odds ratio {aOR}, 37.6], 6–11 months [aOR, 31.9], 12–23 months [aOR, 22.1], 24–59 months [aOR, 7.1], and ≥65 years [aOR, 40.7] compared with 5–24 years of age), underlying medical conditions (aOR, 4.5), human immunodeficiency virus infection (aOR, 4.3), and Streptococcus pneumoniae colonization density ≥1000 deoxyribonucleic acid copies/mL (aOR, 4.8). Underlying medical conditions in children aged <5 years included asthma (aOR, 22.7), malnutrition (aOR, 2.4), and prematurity (aOR, 4.8); in persons aged ≥5 years, conditions included asthma (aOR, 3.6), diabetes (aOR, 7.1), chronic lung diseases (aOR, 10.7), chronic heart diseases (aOR, 9.6), and obesity (aOR, 21.3). Mine workers (aOR, 13.8) and pregnant women (aOR, 12.5) were also at increased risk for influenza-associated hospitalization. Conclusions The risk groups identified in this study may benefit most from annual influenza immunization, and children <6 months of age may be protected through vaccination of their mothers during pregnancy.

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Outcome of Patients Admitted to Intensive Care Units due to Influenza-Related Severe Acute Respiratory Illness in 2017–2018 Flu Season: A Multicenter Study from Turkey

Respiration ◽

10.1159/000511092 ◽

2020 ◽

pp. 1-7

Author(s):

Ebru Ortac Ersoy ◽

Berrin Er ◽

Fatma Ciftci ◽

Aykan Gulleroglu ◽

Kezban Suner ◽

...

Keyword(s):

Intensive Care ◽

Multicenter Study ◽

Hematologic Malignancy ◽

Invasive Mechanical Ventilation ◽

Kidney Injury ◽

Respiratory Illness ◽

Nasopharyngeal Swab ◽

Acute Respiratory Illness ◽

Factors Affecting ◽

Severe Acute Respiratory Illness

Background: Influenza can cause severe acute respiratory illness (SARI), which occurs as local outbreaks or seasonal epidemics with high intensive care unit (ICU) admission and mortality rates. Mortality is mainly due to SARI. Objective: The aim of this study was to evaluate the outcome of patients admitted to ICU due to influenza-related SARI in 2017–2018 flu season in Turkey. Methods: A retrospective multicenter study was conducted in 13 ICUs with a total of 216 beds from 6 cities in Turkey. All adult patients (over 18 years) admitted to the ICUs in 2017–2018 flu season (between September 1, 2017, and April 30, 2018) because of SARI and with a positive nasopharyngeal swab for influenza were included in the study. Results: A total of 123 cases were included in the study. The mean age of patients was 64.5 ± 17.5 years, and 66 (53.7%) patients were older than 65 years. The ICU mortality was 33.9%, and hospital mortality was 35.6%. Invasive mechanical ventilation (IMV), acute kidney injury (AKI), hematologic malignancy, and >65 years of age were the factors affecting mortality in influenza. Conclusion: SARI due to influenza carries a high mortality rate, and IMV, AKI, presence of hematologic malignancy, and older age are independent risk factors for mortality.

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