Clinical Features and Prognostic Factors of Acute Kidney Injury Caused by Adult Secondary Hemophagocytic Lymphohistiocytosis

Abstract Background and Aims Hemophagocytic lymphohistiocytosis (HLH) is a syndrome characterized by overproduction of proinflammatory cytokines and hemophagocytosis. Acute kidney injury (AKI) is the most common complication of HLH in the kidney, which is a strong predictor of poor prognosis. In this retrospective study, we aimed to find the risk factors of AKI in patients with HLH. Method We screened all adult patients with HLH admitted to West China Hospital of Sichuan University from January 2009 to June 2019. Patients in this study were secondary HLH according to the HLH diagnostic criteria revised by the Histocyte Society in 2004. Patients with HLH were excluded from the study if they had a functioning kidney transplant, received renal replacement therapy (RRT) in the past month, suffered from end-stage renal disease (ESRD), or had the renal malignant tumor. We collected basic information, clinical manifestations, and laboratory data of patients from electronic medical records. Results A total of 600 patients with confirmed diagnosis of secondary HLH are included in our analysis. There are 199(33.2%)HLH-induced AKI patients, among whom 37.2%, 32.7%, and 30.2% are classified as AKI I, II, and III, respectively, according to the 2012 KDIGO (Kidney Disease: Improving Global Outcomes) guideline. Overall hospital mortality is 176(29.3%), and the number of deaths in patients with AKI was much higher than that in patients without AKI (53.3% versus 17.5%, P < 0.001). The risk factors of AKI in patients with HLH were hyperphosphatemia (P<0.001, OR 5.448, 95%CI 2.951-10.059) , vasopressor(P<0.001, OR 3.485, 95%CI 2.114-5.746), heart failure (P=0.044, 0R 2.336, 95%CI 1.022-5.340), gastrointestinal symptoms (P=0.043, OR 1.877, 95%CI 1.021-3.453), increased heart rate (P=0.005, OR 1.017, 95%CI 1.005-1.029), elevated total bilirubin level(P<0.001, OR 1.004, 95%CI 1.002-1.007), and hypoproteinemia (P=0.034, OR 0.939, 95%CI 0.886-0.995). Conclusion The incidence of AKI was higher in patients with HLH, and the risk of death was significantly higher in HLH patients with AKI. A variety of risk factors are related to the occurrence of HLH-induced AKI. Identifying and correcting them early in clinical diagnosis and treatment may reduce the incidence of AKI in patients with HLH and improve the prognosis of them.

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A CLINICAL STUDY OF ETIOLOGY, OUTCOME AND PROGNOSTIC FACTORS OF ACUTE KIDNEY INJURY AMONG ICU ADMISSIONS IN RURAL TERTIARY CARE HOSPITAL

10.36106/gjra/9815424 ◽

2021 ◽

pp. 201-204

Author(s):

Shashikantha Shashikantha ◽

Sohil Sharda. ◽

Bernice Robert ◽

Gangurde Bhushan Daulatrao

Keyword(s):

Acute Kidney Injury ◽

Prognostic Factors ◽

Renal Disease ◽

Tertiary Care Hospital ◽

Chronic Renal Disease ◽

Tertiary Care ◽

Ventilatory Support ◽

Kidney Injury ◽

Care Hospital ◽

Study Results

INTRODUCTION: Acute kidney injury is a common occurrence in ICU admissions causing increased morbidity and mortality. Present study aimed to determine the causes and prognostic factors of acute kidney injury in intensive care unit. MATERIAL AND METHODS: This Hospital based Cross sectional Study was conducted at a tertiary care Hospital and Research Center, including 100 patients aged >18 years with Acute Kidney Injury admitted in ICU from the period of October 2018 to June 2020. Patients with chronic renal disease, previous renal transplantation, congenital renal disease were excluded from the study. RESULTS: Most of the patients (63%) were aged above 50 years. Diabetes was found in 55% and hypertension in 26% of AKI cases. Most common cause identied were sepsis, CLD, renal, CNS and CVD. Hypotension occurred in 48% patients, while oliguria occurred in 45% patients. Ventilatory support was required by 43% patients, while 31% patients required haemodialysis. Mortality rate in AKI was 51%. Mortality was signicantly associated with advanced age, presence of Diabetes, and RIFLE criteria. Spot urine <40 meq/L, hyperkalemia, serum creatinine >4 mg/dl, blood urea >100 mg/dl and acidosis were associated with higher mortality. CONCLUSION: Continuous monitoring parameters like Spot Fe Na, Serum Potasium and pH especially in patients at risk, like elderly patients with diabetes, those with sepsis, can help in early identication and appropiate management, thus reduce the incidence or severity of AKI.

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85 Acute Kidney Injury and Hemophagocytic Lymphohistiocytosis (HLH) caused by Human Granulocytic Anaplasmosis (HGA)

American Journal of Kidney Diseases ◽

10.1053/j.ajkd.2019.03.087 ◽

2019 ◽

Vol 73 (5) ◽

pp. 664

Keyword(s):

Acute Kidney Injury ◽

Hemophagocytic Lymphohistiocytosis ◽

Kidney Injury ◽

Human Granulocytic Anaplasmosis ◽

Granulocytic Anaplasmosis

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Acute kidney injury in elderly intensive care patients from a developing country: clinical features and outcome

International Journal of Nephrology and Renovascular Disease ◽

10.2147/ijnrd.s126534 ◽

2017 ◽

Vol Volume 10 ◽

pp. 27-33 ◽

Cited By ~ 3

Author(s):

Laís Gabriela Yokota ◽

Beatriz Motto Sampaio ◽

Erica Rocha ◽

André Luís Balbi ◽

Daniela Ponce

Keyword(s):

Acute Kidney Injury ◽

Intensive Care ◽

Developing Country ◽

Clinical Features ◽

Kidney Injury ◽

Intensive Care Patients

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Prognostic Factors and a Prognostic Index for Cats with Acute Kidney Injury

Journal of Veterinary Internal Medicine ◽

10.1111/j.1939-1676.2012.00920.x ◽

2012 ◽

Vol 26 (3) ◽

pp. 500-505 ◽

Cited By ~ 20

Author(s):

Y.-J. Lee ◽

J.P.-W. Chan ◽

W.-L. Hsu ◽

K.-W. Lin ◽

C.-C. Chang

Keyword(s):

Acute Kidney Injury ◽

Prognostic Factors ◽

Prognostic Index ◽

Kidney Injury

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Prognostic factors for acute kidney injury development in critically ill cancer patients

Critical Care ◽

10.1186/cc10181 ◽

2011 ◽

Vol 15 (S2) ◽

Author(s):

LA Hajjar ◽

H Palomba ◽

J Almeida ◽

J Fukushima ◽

RE Nakamura ◽

...

Keyword(s):

Acute Kidney Injury ◽

Prognostic Factors ◽

Cancer Patients ◽

Critically Ill ◽

Kidney Injury ◽

Acute Kidney Injury Development

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Clinical features of acute kidney injury in patients with nephrotic syndrome and minimal change disease

Chinese Medical Journal ◽

10.1097/cm9.0000000000001218 ◽

2020 ◽

Vol Publish Ahead of Print ◽

Author(s):

Shu-Peng Lin ◽

Feng-Ge Zhu ◽

Jin-Ling Meng ◽

Xiao-Wei Sun ◽

Jing Cui ◽

...

Keyword(s):

Acute Kidney Injury ◽

Nephrotic Syndrome ◽

Clinical Features ◽

Minimal Change Disease ◽

Kidney Injury ◽

Minimal Change

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Clinical Features and Outcomes of Acute Kidney Injury in Patients Infected with COVID-19 in Xiangyang, China

Blood Purification ◽

10.1159/000513163 ◽

2020 ◽

pp. 1-7

Author(s):

Hai Yuan ◽

Jingjing Liu ◽

Zhao Gao ◽

Fengqi Hu

Keyword(s):

Acute Kidney Injury ◽

Renal Replacement Therapy ◽

Replacement Therapy ◽

Clinical Features ◽

Clinical Laboratory ◽

Antiviral Treatment ◽

Kidney Injury ◽

Ground Glass Opacity ◽

Ct Images ◽

Additional Time

Background: In December 2019, pneumonia associated with COVID-19 has spread from Wuhan to other areas in China. In the present study, we aimed to further clarify the clinical features and outcomes of acute kidney injury (AKI) in patients infected with COVID-19 in Xiangyang, Hubei, China. Methods: All confirmed cases of COVID-19 with AKI in Xiangyang Central Hospital from January 22 to May 31, 2020, were included in this retrospective study. Data of epidemiological, clinical, laboratory, radiological tests, treatment, complication, and outcomes were collected and analyzed. Patients were divided into intensive care unit (ICU) group and isolation ward (non-ICU) group. Results: Of the total patients, 33.3% in the non-ICU group and 85.7% in the ICU group had chronic diseases. In addition, 85.7% of patients in the ICU group died. The most common symptoms were fever, cough, and fatigue. The lymphocyte count in the ICU group was significantly reduced compared with the non-ICU group. The chest computed tomography (CT) images appeared showed multiple mottles and ground-glass opacity. Strip shadow could be found in chest CT images of some recovered patients. All patients received antiviral treatment. Most patients in the ICU group were given methylprednisolone, immunoglobulin, antibiotics, and mechanical ventilation and 35.7% of patients in the ICU group received continuous renal replacement therapy. Conclusions: Elderly with chronic comorbidities were more susceptible to COVID-19, showing a higher mortality rate due to multiple organ damage, and 35.7% of patients with AKI in ICU received renal replacement therapy. Moreover, part of the cured patients might need additional time to recover for poor lung function.

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