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Utilizing reclassification to explore characteristics and prognosis of KDIGOSCr AKI subgroups: a retrospective analysis of a multicenter prospective cohort study

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单位: [1]Peking Union Med Coll Hosp, Med Intens Care Unit, 1 Shuai Fu Yuan, Beijing 100730, Peoples R China [2]Peking Univ, Peking Univ Peoples Hosp, Trauma Intens Care Unit, Key Lab Trauma & Neural Regenerat, Beijing, Peoples R China [3]Minist Educ, Beijing, Peoples R China [4]Tsinghua Changgung Hosp, Dept Crit Care Med, Beijing, Peoples R China [5]Peking Univ Peoples Hosp, Dept Crit Care Med, Beijing, Peoples R China [6]Sichuan Univ, West China Hosp, Dept Crit Care Med, Chengdu, Peoples R China [7]Xinjiang Med Univ, Affiliated Hosp 1, Dept Crit Care Med, Urumqi, Peoples R China [8]Harbin Med Univ, Affiliated Hosp 1, Dept Crit Care Med, Harbin, Peoples R China [9]China Med Univ, Dept Crit Care Med, Affiliated Hosp 1, Shenyang, Peoples R China [10]Cent South Univ, Xiangya Hosp, Dept Crit Care Med, Changsha, Peoples R China [11]Capital Med Univ, Beijing Tongren Hosp, Dept Crit Care Med, Beijing, Peoples R China [12]Capital Med Univ, Fuxing Hosp, Dept Crit Care Med, Beijing, Peoples R China [13]Kunming Med Coll, Dept Emergency Med, Affiliated Hosp 1, Kunming, Yunnan, Peoples R China [14]Shandong Univ, Qilu Hosp, Dept Crit Care Med, Jinan, Peoples R China [15]Zhejiang Prov Peoples Hosp, Dept Crit Care Med, Hangzhou, Peoples R China [16]Huazhong Univ Sci & Technol,Tongji Hosp,Tongji Med Coll,Dept Crit Care Med,Wuhan,Peoples R China [17]Hebei Med Univ, Dept Crit Care Med, Hosp 4, Shijiazhuang, Hebei, Peoples R China [18]Ningxia Med Univ, Dept Crit Care Med, Affiliated Hosp, Yinchuan, Ningxia, Peoples R China [19]Chongqing Med Univ, Affiliated Hosp 1, Dept Crit Care Med, Chongqing, Peoples R China [20]Capital Med Univ, Xuanwu Hosp, Dept Crit Care Med, Beijing, Peoples R China [21]Fujian Med Univ, Dept Crit Care Med, Affiliated Hosp 1, Fuzhou, Peoples R China [22]Shanghai Jiao Tong Univ, Ruijin Hosp, Dept Emergency Med, Shanghai, Peoples R China [23]Guangdong Gen Hosp, Dept Crit Care Med, Guangzhou, Peoples R China [24]Hainan Prov Peoples Hosp, Dept Crit Care Med, Haikou, Hainan, Peoples R China [25]Peking Univ Peoples Hosp, Dept Emergency Med, Beijing, Peoples R China
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关键词: Acute kidney injury KDIGO intensive care unit mortality length of stay

摘要:
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.

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出版当年[2020]版:
大类 | 4 区 医学
小类 | 4 区 泌尿学与肾脏学
最新[2025]版:
大类 | 3 区 医学
小类 | 3 区 泌尿学与肾脏学
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出版当年[2019]版:
Q3 UROLOGY & NEPHROLOGY
最新[2023]版:
Q1 UROLOGY & NEPHROLOGY

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第一作者单位: [1]Peking Union Med Coll Hosp, Med Intens Care Unit, 1 Shuai Fu Yuan, Beijing 100730, Peoples R China [2]Peking Univ, Peking Univ Peoples Hosp, Trauma Intens Care Unit, Key Lab Trauma & Neural Regenerat, Beijing, Peoples R China [3]Minist Educ, Beijing, Peoples R China
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