Utilizing reclassification to explore characteristics and prognosis of KDIGO(SCr) AKI subgroups: a retrospective analysis of a multicenter prospective cohort study
机构:[a]Medical Intensive Care Unit, Peking Union Medical College Hospital, Beijing, China[b]Trauma Intensive Care Unit, Peking UniversityPeople’s Hospital, Key Laboratory of Trauma and Neural Regeneration (Peking University) Ministry of Education, Beijing, China[c]Department of Critical Care Medicine, Tsinghua changgung Hospital, Beijing, China[d]Department of Critical Care Medicine, PekingUniversity People’s Hospital, Beijing, China[e]Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu,China四川大学华西医院[f]Department of Critical Care Medicine, First Affiliated Hospital, Xinjiang Medical University, Urumqi, China[g]Department ofCritical Care Medicine, The First Affiliated Hospital, Harbin Medical University, Harbin, China[h]Department of Critical Care Medicine,The First Affiliated Hospital of China Medical University, Shenyang, China[i]Department of Critical Care Medicine, Xiangya Hospital,Central South University, Changsha, China[j]Department of Critical Care Medicine, Beijing Tongren Hospital, Capital Medical University,Beijing, China首都医科大学附属同仁医院[k]Department of Critical Care Medicine, Fuxing Hospital, Capital Medical University, Beijing, China[l]Department ofEmergency Medicine, The First Affiliated Hospital of Kunming Medical College, Kunming, China昆明医科大学附属第一医院[m]Department of Critical CareMedicine, Qilu Hospital, Shandong University, Jinan, China[n]Department of Critical Care Medicine, Zhejiang Provincial People’sHospital, Hangzhou, China[o]Department of Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University ofScience & Technology, Wuhan, China华中科技大学同济医学院附属同济医院[p]Department of Critical Care Medicine, Hebei Medical University Fourth Hospital, Shijiazhuang,China河北医科大学第四医院[q]Department of Critical Care Medicine, Affiliated Hospital of Ningxia Medical University, Yinchuan, China[r]Department ofCritical Care Medicine, The First Affiliated Hospital, Chongqing Medical University, Chongqing, China重庆医科大学附属第一医院[s]Department of Critical CareMedicine, Xuanwu Hospital, Capital Medical University, Beijing, China首都医科大学宣武医院[t]Department of Critical Care Medicine, The First AffiliatedHospital of Fujian Medical University, Fuzhou, China[u]Department of Emergency Medicine, Ruijin Hospital, Shanghai Jiao TongUniversity, Shanghai, China[v]Department of Critical Care Medicine, Guangdong General Hospital, Guangzhou, China广东省人民医院[w]Department ofCritical Care Medicine, Hainan Provincial People’s Hospital, Haikou, China[x]Department of Emergency Medicine, Peking UniversityPeople’s Hospital, Beijing, China
Background Acute kidney injury (AKI) is widespread in the intensive care unit (ICU) and affects patient prognosis. According to Kidney Disease: Improving Global Outcomes (KDIGO) guidelines, the absolute and relative increases of serum creatinine (Scr) are classified into the same stage. Whether the prognosis of the two types of patients is similar in the ICU remains unclear. Methods According to the absolute and relative increase of Scr, AKI stage 1 and stage 3 patients were divided into stage 1a and 1b, stage 3a and 3b groups, respectively. Their demographics, laboratory results, clinical characteristics, and outcomes were analyzed retrospectively. Results Of the 345 eligible cases, we analyzed stage 1 because stage 3a group had only one patient. Using 53 or 61.88 mu mol/L as the reference Scr (Scr(ref)), no significant differences were observed in ICU mortality (P-53 =0.076, P-61.88 =0.070) or renal replacement therapy (RRT) ratio, (P-53 =0.356, P-61.88 =0.471) between stage 1a and 1b, but stage 1b had longer ICU length of stay (LOS) than stage 1a (P-53 <0.001, P-61.88 =0.032). In the Kaplan-Meier survival analysis, no differences were observed in ICU mortality between stage 1a and 1b (P-53 =0.378, P-61.88 =0.255). In a multivariate analysis, respiratory failure [HR = 4.462 (95% CI 1.144-17.401), p = 0.031] and vasoactive drug therapy [HR = 4.023 (95% CI 1.584-10.216), p = 0.003] were found to be independently associated with increased risk of death. Conclusion ICU LOS benefit was more prominent in KDIGO(SCr) AKI stage 1a patients than in stage 1 b. Further prospective studies with a larger sample size are necessary to confirm the effectiveness of reclassification.
基金:
Ministry of Science and Technology of ChinaMinistry of Science and Technology, China [2020YFC0841300]
第一作者机构:[a]Medical Intensive Care Unit, Peking Union Medical College Hospital, Beijing, China[b]Trauma Intensive Care Unit, Peking UniversityPeople’s Hospital, Key Laboratory of Trauma and Neural Regeneration (Peking University) Ministry of Education, Beijing, China
通讯作者:
通讯机构:[a]Medical Intensive Care Unit, Peking Union Medical College Hospital, Beijing, China[*1]Medical Intensive Care Unit, Peking Union Medical College Hospital, 1 Shuai Fu Yuan, Beijing, 100730, China.
推荐引用方式(GB/T 7714):
Gui-Ying Dong,Jun-Ping Qin,Youzhong An,et al.Utilizing reclassification to explore characteristics and prognosis of KDIGO(SCr) AKI subgroups: a retrospective analysis of a multicenter prospective cohort study[J].RENAL FAILURE.2021,43(1):1569-1576.doi:10.1080/0886022X.2021.1997761.
APA:
Gui-Ying Dong,Jun-Ping Qin,Youzhong An,Yan Kang,Xiangyou Yu...&Bin Du.(2021).Utilizing reclassification to explore characteristics and prognosis of KDIGO(SCr) AKI subgroups: a retrospective analysis of a multicenter prospective cohort study.RENAL FAILURE,43,(1)
MLA:
Gui-Ying Dong,et al."Utilizing reclassification to explore characteristics and prognosis of KDIGO(SCr) AKI subgroups: a retrospective analysis of a multicenter prospective cohort study".RENAL FAILURE 43..1(2021):1569-1576