scholarly journals Acute kidney injury at early stage as a negative prognostic indicator of patients with COVID-19: a hospital-based retrospective analysis

2020 ◽  
Author(s):  
Shen Xu ◽  
Lin Fu ◽  
Jun Fei ◽  
Hui-Xian Xiang ◽  
Ying Xiang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Early Stage ◽  
Kidney Injury ◽  
Oxygenation Index ◽  
Prognostic Indicator ◽  
Critical Ill Patients ◽  
Patients With Diabetes ◽  
Independent Risk Factors ◽  
Critical Ill

AbstractCoronavirus disease 2019 (COVID-19) is a newly emerged infection of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and has been pandemic all over the world. This study described acute kidney injury (AKI) at early stage of COVID-19 and its clinical significance. Three-hundred and fifty-five COVID-19 patients with were recruited and clinical data were collected from electronic medical records. Patient’s prognosis was tracked and risk factors of AKI was analyzed. Of 355 COVID-19 patients, common, severe and critical ill cases accounted for 63.1%, 16.9% and 20.0%, respectively. On admission, 56 (15.8%) patients were with AKI. Although AKI was more common in critical ill patients with COVID-19, there was no significant association between oxygenation index and renal functional indices among COVID-19 patients with AKI. By multivariate logistic regression, male, older age and comorbidity with diabetes were three important independent risk factors predicting AKI among COVID-19 patients. Among 56 COVID-19 patients with AKI, 33.9% were died on mean 10.9 day after hospitalization. Fatality rate was obviously higher among COVID-+19 patients with AKI than those without AKI (RR=7.08, P<0.001). In conclusion, male elderly COVID-19 patients with diabetes are more susceptible to AKI. AKI at early stage may be a negative prognostic indicator for COVID-19.

scholarly journals Factors Determining Nephrotoxicity and Mortality in Critical Care Patients Receiving Colistin

2018 ◽  
Vol 11 (12) ◽  
pp. 912-917 ◽  
Author(s):  
Ali Ciftci ◽  
Seval Izdes ◽  
Neriman Defne Altintas
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Demographic Data ◽  
Kidney Injury ◽  
Apache Ii ◽  
Factors Affecting ◽  
Acute Kidney Injury Group ◽  
Injury Group ◽  
Independent Risk Factors ◽  
Critical Patients

Introduction: We aimed to determine risk factors for nephrotoxicity and factors affecting mortality in patients who received colistin. Methodology: Critical patients who received colistin were enrolled. Pregnancy, age < 18 years, basal creatinine level > 2 mg/dL, colistin use for < 48 hours, and previous renal replacement therapy were exclusion criteria. KDIGO stages were determined according to creatinine levels. Patients were grouped as those with no acute kidney injury (Group N0) and those with acute kidney injury (Group N). Their demographic data, APACHE II and SOFA scores, treatments, and laboratory results were recorded. Results: A total of 91 patients were included: 27 in Group N0 and 64 in Group N. Demographic data were similar between groups; however, higher admission APACHE-II scores (OR:1.179, 95% CI:1.033-1.346, p = 0.015) and need for vasopressors (OR:5.486, 95% CI:1.522–19.769, p = 0.009) were found to be independent risk factors for nephrotoxicity. Higher APACHE II scores (OR:1.253, %95 CI:1.093-1.437, p = 0.001), presence of coronary artery disease (OR:7.720, % 95 CI: 1.613-36.956, p = 0.011), need for vasopressors (OR: 4.587, % 95 CI: 1.224 – 17.241, p = 0.024), hypoalbuminemia (OR: 4.721, % 95 CI: 1.088 – 20.469, p = 0.038), and higher direct bilirubin levels (OR: 1.806, % 95 CI: 1.055 – 3.092, p = 0.031) were independent risk factors for mortality. Conclusion: When use of colistin is considered in ICU patients, presence of modifiable risk factors for nephrotoxicity such as hypoalbuminemia, nephrotoxic drug administration, and presence of shock should be determined and managed to prevent nephrotoxicity.

Renal injury study in critical ill patients in accordance with the new definition given by the Acute Kidney Injury Network

2011 ◽  
Vol 26 (2) ◽  
pp. 206-212 ◽  
Author(s):  
Nelson Javier Fonseca Ruiz ◽  
Diana Paola Cuesta Castro ◽  
Ana Milena Mesa Guerra ◽  
Francisco Molina Saldarriaga ◽  
Juan Diego Montejo Hernández
Keyword(s):  
Acute Kidney Injury ◽  
Renal Injury ◽  
Kidney Injury ◽  
Acute Kidney Injury Network ◽  
Critical Ill Patients ◽  
Critical Ill

scholarly journals Incidence, risk factors, and mortality of acute kidney injury within 1-month after lung transplantation

2021 ◽  
Author(s):  
Nam Eun Kim ◽  
Chi Young Kim ◽  
Song Yee Kim ◽  
Ha Eun Kim ◽  
Jin Gu Lee ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Lung Transplantation ◽  
Kidney Injury ◽  
Operative Management ◽  
Rank Test ◽  
Severance Hospital ◽  
Incidence Risk ◽  
Independent Risk Factors ◽  
Grade 3

Abstract Background After lung transplantation (LT), some patients are at risk of acute kidney injury (AKI), which is associated with worse outcomes and increased mortality. Method Among 161 patients who underwent LT at Severance hospital in Seoul, Korea from October 2012 to September 2017, 148 patients were retrospectively enrolled. Results 59 (39.8%) developed AKI within 1-month after LT. Stage I or II, and stage III AKI were recorded in 26 (17.5%) and 33 (22.2%), respectively. AKI III usually occurred within 7 days after transplantation (early vs. late AKI III, 72.5% vs 21.1%). Pre-operative anemia, units of red blood cells transfused during surgery, colistin intravenous infusion for treating multi drug resistant pathogens were independent risk factors for AKI development. Post-operative bleeding, grade 3 PGD within 72 hrs, and sepsis were more common in the AKI group. Patients with AKI III ([24/33] 72.7%) had significantly higher 1-year mortality than the no-AKI ([18/89] 20.2%), and AKI I or II group ([9/26] 34.6%), log-rank test, P < 0.001). Conclusion AKI was associated with worse post-operative outcome, 3-month, and 1-year mortality after LT. Severity of AKI was usually determined in early post op period after LT, so optimal post-operative management as well as recipients selection should be considered.

scholarly journals Clinical course and outcome of 107 patients infected with the novel coronavirus, SARS-CoV-2, discharged from two hospitals in Wuhan, China.

2020 ◽  
Author(s):  
Dawei Wang ◽  
Yimei Yin ◽  
Chang Hu ◽  
Xing Liu ◽  
Xingguo Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Clinical Course ◽  
Case Series ◽  
Kidney Injury ◽  
Retrospective Case ◽  
Illness Onset ◽  
Independent Risk Factors ◽  
Systemic Symptoms ◽  
Novel Coronavirus

Abstract Background In December 2019, Coronavirus Disease 2019 (COVID-19) outbreak was reported from Wuhan, China. Information on the clinical course and prognosis of COVID-19 was not thoroughly described. We described the clinical courses and prognosis in COVID-19 patients. Methods Retrospective case series of COVID-19 patients from Zhongnan Hospital of Wuhan University in Wuhan, and Xi-shui Hospital, Hubei Province, China, up to February 10, 2020. Epidemiological, demographic and clinical data were collected. Clinical course of survivors and non-survivors were compared. Risk factors for death were analyzed. Results A total of 107 discharged patients with COVID-19 were enrolled. The clinical course of COVID-19 presented as a tri-phasic pattern. Week 1 after illness onset was characterized by fever, cough, dyspnea, lymphopenia and radiological multilobar pulmonary infiltrates. In severe cases, thrombocytopenia, acute kidney injury, acute myocardial injury or adult respiratory distress syndrome were observed. During week 2, in mild cases, fever, cough and systemic symptoms began to resolve and platelet count rose to normal range, but lymphopenia persisted. In severe cases, leukocytosis, neutrophilia and deteriorating multi-organ dysfunction were dominant. By week 3, mild cases had clinically resolved except for lymphopenia. However, severe cases showed persistent lymphopenia, severe acute respiratory dyspnea syndrome , refractory shock, anuric acute kidney injury, coagulopathy, thrombocytopenia and death. Older age and male sex were independent risk factors for poor outcome of the illness. Conclusions A period of 7–13 days after illness onset is the critical stage in COVID-19 course. Age and male gender were independent risk factors for death of COVID-19.

Comparison of hemodynamic parameters among continuous, intermittent and hybrid renal replacement therapy in acute kidney injury: a systematic review of randomized clinical trials

2019 ◽  
Author(s):  
Diana Silva Russo ◽  
Claudia Severgnini Eugênio ◽  
Illan George Balestrin ◽  
Clarissa Garcia Rodrigues ◽  
Regis Goulart Rosa ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Clinical Trials ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Randomized Clinical Trials ◽  
Kidney Injury ◽  
Continuous Venovenous Hemofiltration ◽  
Hemodynamic Parameters ◽  
Critical Ill Patients ◽  
Critical Ill

Abstract Backround: The use of renal replacement therapy (RRT) in acute kidney injury (AKI) patients in the intensive care unit (ICU) is associated with high hemodynamic instability leading to a probable increase in hospital mortality. The aim of this study was to compare hemodynamic parameters among continuous, intermittent and hybrid renal replacement therapy in critical ill patients. Methods: We conducted in accordance with the PRISMA guidelines which was registered at the PROSPERO Database (CRD42018086504). Randomized clinical trials involving patients with AKI in the ICU treated with continuous, intermittent or hybrid RRT were included. We investigated the PubMed, Embase and Cochrane databases. Two reviewers independently performed study selection, evaluation of methodological quality and data extraction. Results: Out of 3442 citations retrieved, 12 randomized clinical trials (RCTs) were included, representing 1419 patients. Most of the studies (n=8) did not report or find differences in hemodynamic parameters across different RTT modalities. However, continuous venovenous hemofiltration (CVVH) was associated with a reduction in heart rate (after 1 and 4 hours) in comparison with intermittent haemodialysis (IHD) patients. CVVH was also associated with an increase in systolic blood pressure (after 0.5 and 2h) when compared with patients treated with IHD. In addition, dobutamine doses were higher in patients submitted to continuous venovenous hemodiafiltration (CVVHDF) compared to patients submitted to IHD. Lower baseline mean arterial pressure (MAP), greater MAP variation on dialysis, higher number of pressors at baseline, and increase in pressor dose during dialysis were associated with shorter survival time; and greater MAP variation on dialysis was negatively correlated with renal recovery. Conclusions: Changes in hemodynamic pattern appear be similar in different dialytic methods used in critical ill patients; however continuous venovenous hemofiltration seems be safer than other renal replacement modalities.

scholarly journals Clinical Features and Risk Factors of ICU Admission for COVID-19 Patients with Diabetes

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Ming Lei ◽  
Kashuai Lin ◽  
Yaoqiu Pi ◽  
Xiaomei Huang ◽  
Lixin Fan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Respiratory Rate ◽  
Early Stage ◽  
Binary Logistic Regression ◽  
C Reactive Protein ◽  
Radiographic Findings ◽  
Icu Admission ◽  
Reactive Protein ◽  
Patients With Diabetes ◽  
Independent Risk Factors

Introduction. Previous studies of coronavirus disease 2019 (COVID-19) have focused on the general population. However, diabetes (DM) as one of the most common comorbidities is rarely studied in detail. This study is aimed at describing clinical characteristics and determining risk factors of ICU admission for COVID-19 patients with DM. Methods. Data were extracted from 288 adult patients with laboratory-confirmed COVID-19 from Guangzhou Eighth People’s Hospital. Demographic characteristics, laboratory results, radiographic findings, complications, and treatments were collected and compared between DM and non-DM groups. Binary logistic regression was used to identify the risk factors associated with ICU admission for COVID-19 patients with DM or non-DM. Results. COVID-19 patients with DM showed as older ages, higher levels of C-reactive protein (CRP), myoglobin, alanine transaminase (ALT), and aspartate transaminase (AST). They were also more prone to transfer to the intensive care unit (ICU) for treatment. Multiple regression analysis showed that the following were the independent risk factors for COVID-19 patients with DM that received ICU admission: each 1-year increase in age (odds ratio (OR), 1.07; 95% CI, 1.02-1.13; P = 0.007 ), respiratory rate over 24 times per minute (OR, 5.22; 95% CI, 2.26-16.58; P = 0.016 ), HbA1c greater than 7% (OR, 4.58; 95% CI, 1.82-10.55; P = 0.012 ), and AST higher than 40 U/L (OR, 2.96; 95% CI, 1.58-8.85; P = 0.022 ). In addition, each 1-year increase in age (OR, 1.05; 95% CI, 1.01-1.10; P = 0.006 ), diarrhea (OR, 4.62; 95% CI, 2.01-9.36; P = 0.022 ), respiratory rate over 24 times per minute (OR, 5.13; 95% CI, 1.18-16.82; P = 0.035 ), CRP greater than 10 mg/L (OR, 5.19; 95% CI, 1.37-13.25, P = 0.009 ), and TnI higher than 0.03 μg/L (OR, 6.48; 95% CI, 1.17-21.38; P = 0.036 ) were risk factors for ICU admission of COVID-19 patients with non-DM. Conclusions. The older age, respiratory rate over 24 times per minute, HbA1c greater than 7%, and AST higher than 40 U/L were risk factors of ICU admission for COVID-19 patients with diabetes. Investigating and monitoring these factors could assist in the risk stratification of COVID-19 patients with DM at an early stage.

scholarly journals ACUTE KIDNEY INJURY ASSOCIATED WITH INTRAVENOUS FUROSEMIDE: INCIDENCE, INDEPENDENT RISK FACTORS, AND CLINICAL CONSEQUENCES

2012 ◽  
Vol 59 (13) ◽  
pp. E1036
Author(s):  
James Tisdale ◽  
Heather Wroblewski ◽  
Gilwan Kim ◽  
Brian R. Overholser ◽  
Joanna R. Kingery ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Kidney Injury ◽  
Clinical Consequences ◽  
Independent Risk Factors
Sign in / Sign up

Export Citation Format

Share Document