Kidney and lung crosstalk during critical illness: large-scale cohort study

Tomasi, Alessandra; Xuan, Shi‐Ying; Gajic, Ognjen; Kashani, Kianoush

doi:10.1007/s40620-022-01558-9

Cited by 5 publications

(9 citation statements)

References 25 publications

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“…Five studies reported the timing of AKI development after ARDS (21, 25–28). The pooled estimate for the development of AKI after ARDS was 3.8 days (95% CI, 3.62–4.17; five studies) with no significant heterogeneity ( I 2 = 26.6%; p = 0.24) ( Supplemental Fig.…”

Section: Resultsmentioning

confidence: 99%

“…Comparison between AKI before vs. after ARDS showed that here was no difference in mortality between AKI before and AKI after ARDS with a pooled RR (1.32; 95% CI, 0.79–2.2; two studies) ( 21 , 22 ) ( Supplemental Fig. S5 , http://links.lww.com/CCX/B307 ).…”

Section: Resultsmentioning

confidence: 99%

“…Among the included studies, five reported a median time to AKI development following ARDS ( 1 , 21 , 25 , 26 , 38 ), averaging around 4 days. However, differences in AKI timing definitions in these studies make it challenging to interpret effect estimates with high confidence.…”

Section: Discussionmentioning

confidence: 99%

“…To address the potential ambiguity arising from the simultaneous occurrence of AKI with ARDS, we conducted a separate analysis focusing on studies that reported the development of AKI at least 48 hours after the initial diagnosis of ARDS (19)(20)(21)(22)(23). By excluding cases of AKI within the initial 48 hours, we aimed to investigate AKI incidence beyond the immediate association with ARDS diagnosis.…”

Section: Incidence Of Aki After Ardsmentioning

confidence: 99%

“…A total of 12 studies reported the mortality of patients who developed AKI after ARDS compared with those who did not develop AKI (19,(21)(22)(23)(27)(28)(29)(30)(31)(32)(33). The follow-up time to mortality varied in different studies.…”

Section: Impact Of Aki On Mortality In Ardsmentioning

confidence: 99%

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Temporal Relationship and Clinical Outcomes of Acute Kidney Injury Following Acute Respiratory Distress Syndrome: A Systematic Review and Meta-Analysis

Charkviani,

Truong,

Nikravangolsefid

et al. 2024

Critical Care Explorations

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OBJECTIVES: Conduct a systematic review and meta-analysis to assess prevalence and timing of acute kidney injury (AKI) development after acute respiratory distress syndrome (ARDS) and its association with mortality. DATA SOURCES: Ovid MEDLINE(R), Ovid Embase, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, Ovid PsycINFO database, Scopus, and Web of Science thought April 2023. STUDY SELECTION: Titles and abstracts were screened independently and in duplicate to identify eligible studies. Randomized controlled trials and prospective or retrospective cohort studies reporting the development of AKI following ARDS were included. DATA EXTRACTION: Two reviewers independently extracted data using a pre piloted abstraction form. We used Review Manager 5.4 software (Cochrane Library, Oxford, United Kingdom) and Open Meta software (Brown University, Providence, RI) for statistical analyses. DATA SYNTHESIS: Among the 3646 studies identified and screened, 17 studies comprising 9359 ARDS patients met the eligibility criteria and were included in the meta-analysis. AKI developed in 3287 patients (40%) after the diagnosis of ARDS. The incidence of AKI at least 48 hours after ARDS diagnosis was 20% (95% CI, 0.18–0.21%). The pooled risk ratio (RR) for the hospital (or 30-d) mortality among ARDS patients who developed AKI was 1.93 (95% CI, 1.71–2.18). AKI development after ARDS was identified as an independent risk factor for mortality in ARDS patients, with a pooled odds ratio from multivariable analysis of 3.69 (95% CI, 2.24–6.09). Furthermore, two studies comparing mortality between patients with late vs. early AKI initiation after ARDS revealed higher mortality in late AKI patients with RR of 1.46 (95% CI, 1.19–1.8). However, the certainty of evidence for most outcomes was low to very low. CONCLUSIONS: While our findings highlight a significant association between ARDS and subsequent development of AKI, the low to very low certainty of evidence underscores the need for cautious interpretation. This systematic review identified a significant knowledge gap, necessitating further research to establish a more definitive understanding of this relationship and its clinical implications.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Incidence Of Aki After Ardsmentioning

confidence: 99%

Section: Impact Of Aki On Mortality In Ardsmentioning

confidence: 99%

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Temporal Relationship and Clinical Outcomes of Acute Kidney Injury Following Acute Respiratory Distress Syndrome: A Systematic Review and Meta-Analysis

Charkviani,

Truong,

Nikravangolsefid

et al. 2024

Critical Care Explorations

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Development of a predictive nomogram for acute respiratory distress syndrome in patients with acute pancreatitis complicated with acute kidney injury

Yang,

Kang,

et al. 2023

Renal Failure

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Background Acute respiratory distress syndrome (ARDS) is a common complication in patients with acute pancreatitis (AP), especially when patients complicated with acute kidney injury (AKI), resulting in increased duration of hospitalization and mortality. It is of potential clinical significance to develop a predictive model to identify the the high-risk patients. Method AP patients complicated with AKI from January 2019 to March 2022 were enrolled in this study and randomly divided into training cohort and validation cohort at a ratio of 2:1. The Least absolute shrinkage and selection operator(LASSO) regression and machine learning algorithms were applied to select features. A nomogram was developed based on the multivariate logistic regression. The performance of the nomogram was evaluated by AUC, calibration curves, and decision curve analysis. Results A total of 292 patients were enrolled in the study, with 206 in the training cohort and 86 in the validation cohort. Multivariate logistic analysis showed that IAP (Odds Ratio (OR)=4.60, 95%CI:1.23-18.24, p = 0.02), shock (OR = 12.99, 95%CI:3.47-64.04, p < 0.001), CRP(OR= 26.19, 95%CI:9.37-85.57, p < 0.001), LDH (OR = 13.13, 95%CI:4.76-40.42, p < 0.001) were independent predictors of ARDS. The nomogram was developed based on IAP, shock, CRP and LDH. The nomogram showed good discriminative ability with an AUC value of 0.954 and 0.995 in the training and validation cohort, respectively. The calibration curve indicating good concordance between the predicted and observed values. The DCA showed favorable net clinical benefit. Conclusion This study developed a simple model for predicting ARDS in AP patients complicated with AKI. The nomogram can help clinicians identify high-risk patients and optimize therapeutic strategies.

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The Interaction of Acute Kidney Injury with Resuscitation Strategy in Sepsis: A Secondary Analysis of a Multicenter, Phase 3, Randomized Clinical Trial (CLOVERS)

Khader,

Zelnick,

Sathe

et al. 2023

Am J Respir Crit Care Med

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Kidney and lung crosstalk during critical illness: large-scale cohort study

Cited by 5 publications

References 25 publications

Temporal Relationship and Clinical Outcomes of Acute Kidney Injury Following Acute Respiratory Distress Syndrome: A Systematic Review and Meta-Analysis

Temporal Relationship and Clinical Outcomes of Acute Kidney Injury Following Acute Respiratory Distress Syndrome: A Systematic Review and Meta-Analysis

Development of a predictive nomogram for acute respiratory distress syndrome in patients with acute pancreatitis complicated with acute kidney injury

The Interaction of Acute Kidney Injury with Resuscitation Strategy in Sepsis: A Secondary Analysis of a Multicenter, Phase 3, Randomized Clinical Trial (CLOVERS)

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