Acute kidney injury in critically ill patients with pandemic influenza A pneumonia 2009 in Korea: A multicenter study

Jung, Ji Ye; Park, Byung Hoon; Hong, Sang‐Bum; Koh, Younsuck; Suh, Gee Young; Jeon, Kyeongman; Koh, Shin Ok; Kim, Jae Yeol; Cho, Jae Hwa; Choi, Hye Sook; Park, Yong Bum; Kim, Ho Cheol; Kim, So Hyun; Lim, Chang Young; Park, Moo Suk

doi:10.1016/j.jcrc.2011.02.012

Cited by 44 publications

(49 citation statements)

References 25 publications

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“…In our study, the incidence of AKI complicating the course of pH1N1-related critical illness in Canada was higher than reported from Spain (17.7%) [23], South Korea (22.6%) [19], Australia and New Zealand (34.0%) [26], United States (42.0%) [16], and similar to that reported in Argentina (51.0%) [24,25]. Many risk factors for AKI identified in our cohort, specifically older age [15,19], diabetes [19,23,26], CKD [16,19,26], and illness severity [13,19,23,25,26] have been consistently shown to predict AKI in prior studies.…”

Section: Discussioncontrasting

confidence: 56%

“…Recently, reports have described the incidence and outcomes of AKI among critically ill adult and pediatric pH1N1 patients [13]–[28]. Many studies, however, were limited by design (case reports [14,17,20,22,24,28] or small case series [13,15,18,21,27]), small sample size [16,19,25], or single-center enrollment [13,15,16,18,21]. There have been few larger scale prospective multi-center cohorts [19,23,26], none of which described the Canadian pandemic.…”

Section: Introductionmentioning

confidence: 99%

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Acute kidney injury among critically ill patients with pandemic H1N1 influenza A in Canada: cohort study

et al. 2013

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BackgroundCanada’s pandemic H1N1 influenza A (pH1N1) outbreak led to a high burden of critical illness. Our objective was to describe the incidence of AKI (acute kidney injury) in these patients and risk factors for AKI, renal replacement therapy (RRT), and mortality.MethodsFrom a prospective cohort of critically ill adults with confirmed or probable pH1N1 (16 April 2009–12 April 2010), we abstracted data on demographics, co-morbidities, acute physiology, AKI (defined by RIFLE criteria for Injury or Failure), treatments in the intensive care unit, and clinical outcomes. Univariable and multivariable logistic regression analyses were used to evaluate the associations between clinical characteristics and the outcomes of AKI, RRT, and hospital mortality.ResultsWe included 562 patients with pH1N1-related critical illness (479 [85.2%] confirmed, 83 [14.8%] probable]: mean age 48.0 years, 53.4% female, and 13.3% aboriginal. Common co-morbidities included obesity, diabetes, and chronic obstructive pulmonary disease. AKI occurred in 60.9%, with RIFLE categories of Injury (23.0%) and Failure (37.9%). Independent predictors of AKI included obesity (OR 2.94; 95%CI, 1.75-4.91), chronic kidney disease (OR 4.50; 95%CI, 1.46-13.82), APACHE II score (OR per 1-unit increase 1.06; 95%CI, 1.03-1.09), and PaO2/FiO2 ratio (OR per 10-unit increase 0.98; 95%CI, 0.95-1.00). Of patients with AKI, 24.9% (85/342) received RRT and 25.8% (85/329) died. Independent predictors of RRT were obesity (OR 2.25; 95% CI, 1.14-4.44), day 1 mechanical ventilation (OR 4.09; 95% CI, 1.21-13.84), APACHE II score (OR per 1-unit increase 1.07; 95% CI, 1.03-1.12), and day 1 creatinine (OR per 10 μmol/L increase, 1.06; 95%CI, 1.03-1.10). Development of AKI was not independently associated with hospital mortality.ConclusionThe incidence of AKI and RRT utilization were high among Canadian patients with critical illness due to pH1N1.

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Section: Discussioncontrasting

confidence: 56%

Section: Introductionmentioning

confidence: 99%

Acute kidney injury among critically ill patients with pandemic H1N1 influenza A in Canada: cohort study

et al. 2013

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“…Despite this large body of evidence suggesting an interaction between respiratory failure and AKI, few studies have evaluated the effect of respiratory failure on renal function by clearly assessing the time of mechanical ventilation initiation relative to the onset of AKI (27)(28)(29)(30)(31)(32). A recent meta-analysis of these studies suggested that both ARDS and mechanical ventilation were associated with a 3-fold increase in the risk of AKI (46).…”

Section: Discussionmentioning

confidence: 99%

“…Few studies have specifically addressed the association between respiratory failure and AKI (27)(28)(29)(30)(31)(32). In addition, most of these studies were performed in specific patient populations and failed to adequately address the effect of ARDS on renal function (27,(29)(30)(31)(32).…”

Section: Introductionmentioning

confidence: 99%

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Acute Respiratory Distress Syndrome and Risk of AKI among Critically Ill Patients

Darmon¹,

Clec’h²,

Adrie³

et al. 2014

Clinical Journal of the American Society of Nephrology

170

159

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Background and objectives Increasing experimental evidence suggests that acute respiratory distress syndrome (ARDS) may promote AKI. The primary objective of this study was to assess ARDS as a risk factor for AKI in critically ill patients.Design, setting, participants, & measurements This was an observational study on a prospective database fed by 18 intensive care units (ICUs). Patients with ICU stays .24 hours were enrolled over a 14-year period. ARDS was defined using the Berlin criteria and AKI was defined using the Risk, Injury, Failure, Loss of kidney function, and End-stage kidney disease criteria. Patients with AKI before ARDS onset were excluded.Results This study enrolled 8029 patients, including 1879 patients with ARDS. AKI occurred in 31.3% of patients and was more common in patients with ARDS (44.3% versus 27.4% in patients without ARDS; P,0.001). After adjustment for confounders, both mechanical ventilation without ARDS (odds ratio [OR], 4.34; 95% confidence interval [95% CI], 3.71 to 5.10) and ARDS (OR, 11.01; 95% CI, 6.83 to 17.73) were independently associated with AKI. Hospital mortality was 14.2% (n=1140) and was higher in patients with ARDS (27.9% versus 10.0% in patients without ARDS; P,0.001) and in patients with AKI (27.6% versus 8.1% in those without AKI; P,0.001). AKI was associated with higher mortality in patients with ARDS (42.3% versus 20.2%; P,0.001).Conclusions ARDS was independently associated with AKI. This study suggests that ARDS should be considered as a risk factor for AKI in critically ill patients.

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Corticosteroids as adjunctive therapy in the treatment of influenza

Lansbury

Rodrigo

Leonardi‐Bee

et al. 2019

Cochrane Database of Systematic Reviews

188

160

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Background Specific treatments for influenza are limited to neuraminidase inhibitors and adamantanes. Corticosteroids show evidence of benefit in sepsis and related conditions, most likely due to their anti-inflammatory and immunomodulatory properties. Although commonly prescribed for severe influenza, there is uncertainty over their potential benefits or harms. This is an update of a review first published in 2016. Objectives To systematically assess the e ectiveness and potential adverse e ects of corticosteroids as adjunctive therapy in the treatment of influenza, taking into account di erences in timing and doses of corticosteroids.

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Acute kidney injury in critically ill patients with pandemic influenza A pneumonia 2009 in Korea: A multicenter study

Cited by 44 publications

References 25 publications

Acute kidney injury among critically ill patients with pandemic H1N1 influenza A in Canada: cohort study

Acute kidney injury among critically ill patients with pandemic H1N1 influenza A in Canada: cohort study

Acute Respiratory Distress Syndrome and Risk of AKI among Critically Ill Patients

Corticosteroids as adjunctive therapy in the treatment of influenza

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