Utilizing reclassification to explore characteristics and prognosis of KDIGOSCr AKI subgroups: a retrospective analysis of a multicenter prospective cohort study
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四川大学华西医院[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首都医科大学附属北京同仁医院首都医科大学附属同仁医院[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云南省第一人民医院[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华中科技大学同济医学院附属同济医院急诊医学科[17]Hebei Med Univ, Dept Crit Care Med, Hosp 4, Shijiazhuang, Hebei, Peoples R China河北医科大学第四医院[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重庆医科大学附属第一医院[20]Capital Med Univ, Xuanwu Hosp, Dept Crit Care Med, Beijing, Peoples R China首都医科大学宣武医院[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广东省人民医院[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
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 China [2020YFC0841300]
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
通讯作者:
推荐引用方式(GB/T 7714):
Dong Gui-Ying,Qin Jun-Ping,An Youzhong,et al.Utilizing reclassification to explore characteristics and prognosis of KDIGOSCr 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:
Dong, Gui-Ying,Qin, Jun-Ping,An, Youzhong,Kang, Yan,Yu, Xiangyou...&Du, Bin.(2021).Utilizing reclassification to explore characteristics and prognosis of KDIGOSCr AKI subgroups: a retrospective analysis of a multicenter prospective cohort study.RENAL FAILURE,43,(1)
MLA:
Dong, Gui-Ying,et al."Utilizing reclassification to explore characteristics and prognosis of KDIGOSCr AKI subgroups: a retrospective analysis of a multicenter prospective cohort study".RENAL FAILURE 43..1(2021):1569-1576