MP217DIABETES MELLITUS DOES NOT INCREASE THE INCIDENCE OF ACUTE KIDNEY INJURY AFTER CARDIAC SURGERY IN PATIENTS WITH CHRONIC KIDNEY DISEASE; A NESTED CASE-CONTROL STUDY

Abstract Background Acute kidney injury (AKI) may develop in COVID-19 patients and may be associated with a worse outcome. The aim of this study is to describe AKI incidence during the first 45 days of the SARS-CoV2 pandemic in Spain, its reversibility and the association with mortality. Methods Observational retrospective case-control study based on patients hospitalized between March 1 and April 15, 2020 with SARS-CoV2 infection and AKI. Confirmed AKI cases were compared with stable kidney function patients for baseline characteristics, analytical data, treatment and renal outcome. Patients with end-stage kidney disease were excluded. Results AKI incidence was 17.22% among 3182 admitted COVID-19 patients and acute kidney disease (AKD) incidence was 6.82%. The most frequent causes of AKI were prerenal (68.8%) and sepsis (21.9%). Odds ratio for AKI was increased in patients with pre-existent hypertension (OR 2.58, 95% CI 1.71-3.89) and chronic kidney disease (OR 2.14, 95% CI 1.33-3.42) and in those with respiratory distress (OR 2.37, 95% CI 1.52-3.70). Low arterial pressure at admission increased the risk for stage 3 AKI (OR 1.65, 95% CI 1.09-2.50). Baseline kidney function was not recovered in 45.73% of overall AKI cases and in 52.75% of AKI patients with prior chronic kidney disease. Mortality was 38.5% compared to 13.4% of the overall sample population. AKI increased mortality risk at any time of hospitalization (HR 1.45, 95% CI 1.09-1.93). Conclusions AKI is frequent in COVID-19 patients and is associated to mortality, independently from acute respiratory distress syndrome. AKD was also frequent and merits adequate follow-up.

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Diabetes mellitus does not affect the incidence of acute kidney injury after cardiac surgery; a nested case–control study

Journal of Nephrology ◽

10.1007/s40620-016-0281-x ◽

2016 ◽

Vol 29 (6) ◽

pp. 835-845

Author(s):

Maria Moschopoulou ◽

Foteini Ch. Ampatzidou ◽

Charalampos Loutradis ◽

Afroditi Boutou ◽

Charilaos-Panagiotis Koutsogiannidis ◽

...

Keyword(s):

Diabetes Mellitus ◽

Acute Kidney Injury ◽

Cardiac Surgery ◽

Case Control Study ◽

Kidney Injury ◽

Case Control ◽

Nested Case Control ◽

Control Study

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Faculty Opinions recommendation of Intraoperative renal near-infrared spectroscopy indicates developing acute kidney injury in infants undergoing cardiac surgery with cardiopulmonary bypass: a case-control study.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.725330551.793503647 ◽

2015 ◽

Author(s):

Claudio Ronco ◽

Zaccaria Ricci

Keyword(s):

Acute Kidney Injury ◽

Cardiac Surgery ◽

Infrared Spectroscopy ◽

Cardiopulmonary Bypass ◽

Near Infrared Spectroscopy ◽

Near Infrared ◽

Case Control Study ◽

Kidney Injury ◽

Case Control ◽

Control Study

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Association of proton pump inhibitors and concomitant drugs with risk of acute kidney injury: a nested case–control study

BMJ Open ◽

10.1136/bmjopen-2020-041543 ◽

2021 ◽

Vol 11 (2) ◽

pp. e041543

Author(s):

Keiko Ikuta ◽

Shunsaku Nakagawa ◽

Kenji Momo ◽

Atsushi Yonezawa ◽

Kotaro Itohara ◽

...

Keyword(s):

Acute Kidney Injury ◽

Proton Pump Inhibitors ◽

Proton Pump ◽

Case Control Study ◽

Kidney Injury ◽

Case Control ◽

Renal Diseases ◽

Increased Risk ◽

Nested Case Control ◽

Control Study

ObjectivesThis study aimed to assess whether the combined use of proton pump inhibitors (PPIs) with non-steroidal anti-inflammatory drugs (NSAIDs) or antibiotics (penicillins, macrolides, cephalosporins or fluoroquinolones) was associated with an increased risk of acute kidney injury (AKI).DesignA nested case–control study.SettingA health insurance claims database constructed by the Japan Medical Data Center.ParticipantsPatients were eligible if they were prescribed a PPI, NSAID and antibiotic at least once between January 2005 and June 2017. The patients who were new PPI users and did not have any history of renal diseases before cohort entry were included (n=219 082). The mean age was 45 and 44% were women.InterventionsCurrent use of PPIs, NSAIDs, or antibiotics.Primary outcome measuresAcute kidney injury.ResultsDuring a mean follow-up of 2.4 (SD, 1.7) years, 317 cases of AKI were identified (incidence rate of 6.1/10 000 person-years). The current use of PPIs was associated with a higher risk of AKI compared with past PPI use (unadjusted OR, 4.09; 95% CI, 3.09 to 5.44). The unadjusted ORs of AKI for the current use of PPIs with NSAIDs, cephalosporins and fluoroquinolones, compared with the current use of PPIs alone, were 3.92 (95% CI, 2.40 to 6.52), 2.57 (1.43 to 4.62) and 3.08 (1.50 to 6.38), respectively. The effects of concurrent use of PPIs with NSAIDs, cephalosporins or fluoroquinolones remain significant in the adjusted model. The analyses on absolute risk of AKI confirmed the results from the nested case–control study.ConclusionsConcomitant use of NSAIDs with PPIs significantly increased the risk for AKI. Moreover, the results suggested that concomitant use of cephalosporins or fluoroquinolones with PPIs was associated with increased risk of incident AKI.

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