scholarly journals Acute kidney injury prevalence, progression and long-term outcomes in critically ill patients with COVID-19: a cohort study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Nuttha Lumlertgul ◽  
Leah Pirondini ◽  
Enya Cooney ◽  
Waisun Kok ◽  
John Gregson ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Critically Ill ◽  
Steroid Therapy ◽  
Critically Ill Patients ◽  
Kidney Injury ◽  
Renal Recovery ◽  
Long Term Outcomes ◽  
Icu Admission

Abstract Background There are limited data on acute kidney injury (AKI) progression and long-term outcomes in critically ill patients with coronavirus disease-19 (COVID-19). We aimed to describe the prevalence and risk factors for development of AKI, its subsequent clinical course and AKI progression, as well as renal recovery or dialysis dependence and survival in this group of patients. Methods This was a retrospective observational study in an expanded tertiary care intensive care unit in London, United Kingdom. Critically ill patients admitted to ICU between 1st March 2020 and 31st July 2020 with confirmed SARS-COV2 infection were included. Analysis of baseline characteristics, organ support, COVID-19 associated therapies and their association with mortality and outcomes at 90 days was performed. Results Of 313 patients (70% male, mean age 54.5 ± 13.9 years), 240 (76.7%) developed AKI within 14 days after ICU admission: 63 (20.1%) stage 1, 41 (13.1%) stage 2, 136 (43.5%) stage 3. 113 (36.1%) patients presented with AKI on ICU admission. Progression to AKI stage 2/3 occurred in 36%. Risk factors for AKI progression were mechanical ventilation [HR (hazard ratio) 4.11; 95% confidence interval (CI) 1.61–10.49] and positive fluid balance [HR 1.21 (95% CI 1.11–1.31)], while steroid therapy was associated with a reduction in AKI progression (HR 0.73 [95% CI 0.55–0.97]). Kidney replacement therapy (KRT) was initiated in 31.9%. AKI patients had a higher 90-day mortality than non-AKI patients (34% vs. 14%; p < 0.001). Dialysis dependence was 5% at hospital discharge and 4% at 90 days. Renal recovery was identified in 81.6% of survivors at discharge and in 90.9% at 90 days. At 3 months, 16% of all AKI survivors had chronic kidney disease (CKD); among those without renal recovery, the CKD incidence was 44%. Conclusions During the first COVID-19 wave, AKI was highly prevalent among severely ill COVID-19 patients with a third progressing to severe AKI requiring KRT. The risk of developing CKD was high. This study identifies factors modifying AKI progression, including a potentially protective effect of steroid therapy. Recognition of risk factors and monitoring of renal function post-discharge might help guide future practice and follow-up management strategies. Trial registration NCT04445259

LONG-TERM OUTCOME AFTER ACUTE KIDNEY INJURY IN CRITICALLY-ILL PATIENTS

2007 ◽  
Vol 62 (sup2) ◽  
pp. 337-340 ◽  
Author(s):  
S. Oeyen ◽  
D. Vandijck ◽  
D. Benoit ◽  
J. Decruyenaere ◽  
L. Annemansc ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Kidney Injury ◽  
Term Outcome ◽  
Long Term Outcome

Acute kidney injury following coronary angiography: a nationwide study of incidence, risk factors and long-term outcomes

2018 ◽  
Vol 31 (5) ◽  
pp. 721-730 ◽  
Author(s):  
Dadi Helgason ◽  
Thorir E. Long ◽  
Solveig Helgadottir ◽  
Runolfur Palsson ◽  
Gisli H. Sigurdsson ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Coronary Angiography ◽  
Kidney Injury ◽  
Long Term Outcomes ◽  
Nationwide Study ◽  
Incidence Risk

scholarly journals Anemia Is a Risk Factor for Acute Kidney Injury and Long-Term Mortality in Critically Ill Patients

2015 ◽  
Vol 237 (4) ◽  
pp. 287-295 ◽  
Author(s):  
Seung Seok Han ◽  
Seon Ha Baek ◽  
Shin Young Ahn ◽  
Ho Jun Chin ◽  
Ki Young Na ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Risk Factor ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Kidney Injury ◽  
Long Term Mortality

scholarly journals Association between serum levels of interleukin-6 on ICU admission and subsequent outcomes in critically ill patients with acute kidney injury

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Takashi Shimazui ◽  
Taka-aki Nakada ◽  
Yoshihisa Tateishi ◽  
Taku Oshima ◽  
Tuerxun Aizimu ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Interleukin 6 ◽  
Kidney Injury ◽  
Serum Levels ◽  
Icu Admission

scholarly journals Influence of acute kidney injury on short- and long-term outcomes in patients undergoing cardiac surgery: risk factors and prognostic value of a modified RIFLE classification

Critical Care ◽  
2013 ◽  
Vol 17 (6) ◽  
pp. R293 ◽  
Author(s):  
Juan C Lopez-Delgado ◽  
Francisco Esteve ◽  
Herminia Torrado ◽  
David Rodríguez-Castro ◽  
Maria L Carrio ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Cardiac Surgery ◽  
Prognostic Value ◽  
Kidney Injury ◽  
Long Term Outcomes ◽  
Rifle Classification ◽  
Short And Long Term

scholarly journals Elevated serum galectin-1 concentrations are associated with increased risks of mortality and acute kidney injury in critically ill patients

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257558
Author(s):  
Ruey-Hsing Chou ◽  
Chuan-Tsai Tsai ◽  
Ya-Wen Lu ◽  
Jiun-Yu Guo ◽  
Chi-Ting Lu ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Critically Ill ◽  
Sofa Score ◽  
Critically Ill Patients ◽  
Medical Center ◽  
Elevated Serum ◽  
Kidney Injury ◽  
The Body ◽  
Icu Admission ◽  
Increased Risk

Background Galectin-1 (Gal-1), a member of the β-galactoside binding protein family, is associated with inflammation and chronic kidney disease. However, the effect of Gal-1 on mortality and acute kidney injury (AKI) in critically-ill patients remain unclear. Methods From May 2018 to March 2020, 350 patients admitted to the medical intensive care unit (ICU) of Taipei Veterans General Hospital, a tertiary medical center, were enrolled in this study. Forty-one patients receiving long-term renal replacement therapy were excluded. Serum Gal-1 levels were determined within 24 h of ICU admission. The patients were divided into tertiles according to their serum Gal-1 levels (low, serum Gal-1 < 39 ng/ml; median, 39–70 ng/ml; high, ≥71 ng/ml). All patients were followed for 90 days or until death. Results Mortality in the ICU and at 90 days was greater among patients with elevated serum Gal-1 levels. In analyses adjusted for the body mass index, malignancy, sepsis, Sequential Organ Failure Assessment (SOFA) score, and serum lactate level, the serum Gal-1 level remained an independent predictor of 90-day mortality [median vs. low: adjusted hazard ratio (aHR) 2.11, 95% confidence interval (CI) 1.24–3.60, p = 0.006; high vs. low: aHR 3.21, 95% CI 1.90–5.42, p < 0.001]. Higher serum Gal-1 levels were also associated with a higher incidence of AKI within 48 h after ICU admission, independent of the SOFA score and renal function (median vs. low: aHR 2.77, 95% CI 1.21–6.34, p = 0.016; high vs. low: aHR 2.88, 95% CI 1.20–6.88, p = 0.017). The results were consistent among different subgroups with high and low Gal-1 levels. Conclusion Serum Gal-1 elevation at the time of ICU admission were associated with an increased risk of mortality at 90 days, and an increased incidence of AKI within 48 h after ICU admission.

Long-Term Outcomes and Associated Risk Factors of Post-Hospitalization Dialysis-Dependent Acute Kidney Injury Patients

Nephron ◽  
2017 ◽  
Vol 137 (2) ◽  
pp. 105-112 ◽  
Author(s):  
Ajay S. Rathore ◽  
Tushar Chopra ◽  
Jennie Z. Ma ◽  
Wenjun Xin ◽  
Emaad M. Abdel-Rahman
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Kidney Injury ◽  
Long Term Outcomes ◽  
Associated Risk Factors

scholarly journals Fluctuations in Serum Chloride and Acute Kidney Injury among Critically Ill Patients: A Retrospective Association Study

2019 ◽  
Vol 8 (4) ◽  
pp. 447 ◽  
Author(s):  
Tak Kyu Oh ◽  
In-Ae Song ◽  
Young-Tae Jeon ◽  
You Hwan Jo
Keyword(s):  
Acute Kidney Injury ◽  
Confidence Interval ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Odds Ratio ◽  
Kidney Injury ◽  
Icu Admission ◽  
Serum Chloride ◽  
Increased Risk ◽  
The Difference

Exposure to dyschloremia among critically ill patients is associated with an increased risk of acute kidney injury (AKI). We aimed to investigate how fluctuations in serum chloride (Cl−) are associated with the development of AKI in critically ill patients. We retrospectively analyzed medical records of adult patients admitted to the intensive care unit (ICU) between January 2012 and December 2017. Positive and negative fluctuations in Cl− were defined as the difference between the baseline Cl- and maximum Cl- levels and the difference between the baseline Cl− and minimum Cl− levels measured within 72 h after ICU admission, respectively. In total, 19,707 patients were included. The odds of developing AKI increased 1.06-fold for every 1 mmol L−1 increase in the positive fluctuations in Cl− (odds ratio: 1.06; 95% confidence interval: 1.04 to 1.08; p < 0.001) and 1.04-fold for every 1 mmol L−1 increase in the negative fluctuations in Cl− (odds ratio: 1.04; 95% confidence interval: 1.02 to 1.06; p < 0.001). Increases in both the positive and negative fluctuations in Cl- after ICU admission were associated with an increased risk of AKI. Furthermore, these associations differed based on the functional status of the kidneys at ICU admission or postoperative ICU admission.

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