Risk factors for death among critically ill patients with acute renal failure

Júnior, Geraldo Bezerra da Silva; Daher, Elizabeth De Francesco; Mota, Rosa Maria Salani; Menezes, Francisco Albano

doi:10.1590/s1516-31802006000500004

Cited by 38 publications

(12 citation statements)

References 43 publications

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“…(14) In our cohort, the patients with AKI were of similar age to those without AKI, and their age was similar to the findings reported by other studies conducted in our region. (7,15,16) The ICU length of stay was similar in patients with and without AKI, most likely due to the severity of pulmonary disease in both groups.…”

Section: Discussionmentioning

confidence: 91%

“…Previous studies have described AKI, as well as respiratory insufficiency, as independent risk factors for death in critically ill patients. (7,20) It is known that ALI and the consequent hypoxemia, hypercapnia and MV that arise from it worsens renal hemodynamics. This could have increased mortality among the studied cases.…”

Section: Discussionmentioning

confidence: 99%

“…(4-6) The association between AKI and the need for mechanical ventilation (MV) has been demonstrated in past studies, suggesting a possible link between AKI and lung involvement. (3,7) …”

Section: Introductionmentioning

confidence: 99%

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Acute kidney injury in critically ill patients with lung disease: kidney-lung crosstalk

Abreu¹,

Silva²,

Muniz³

et al. 2013

Revista Brasileira De Terapia Intensiva

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ObjectiveTo examine the factors associated with acute kidney injury and outcome in patients with lung disease. MethodsA prospective study was conducted with 100 consecutive patients admitted to a respiratory intensive care unit in Fortaleza (CE), Brazil. The risk factors for acute kidney injury and mortality were investigated in a group of patients with lung diseases. ResultsThe mean age of the study population was 57 years, and 50% were male. The incidence of acute kidney injury was higher in patients with PaO2/FiO2<200 mmHg (54% versus 23.7%; p=0.02). Death was observed in 40 cases and the rate of mortality of the acute kidney injury group was higher (62.8% versus 27.6%; p=0.01). The independent factor that was found to be associated with acute kidney injury was PaO2/FiO2<200 mmHg (p=0.01), and the independent risk factors for death were PEEP at admission (OR: 3.6; 95%CI: 1.3-9.6; p=0.009) and need for hemodialysis (OR: 7.9; 95%CI: 2.2-28.3; p=0.001). ConclusionThere was a higher mortality rate in the acute kidney injury group. Increased mortality was associated with mechanical ventilation, high PEEP, urea and need for dialysis. Further studies must be performed to better establish the relationship between kidney and lung injury and its impact on patient outcome.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

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Acute kidney injury in critically ill patients with lung disease: kidney-lung crosstalk

Abreu¹,

Silva²,

Muniz³

et al. 2013

Revista Brasileira De Terapia Intensiva

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“…Often this disorder is a marker for underlying pathology, and the most commonly encountered causes of metabolic acidosis are renal insufficiency, sepsis, and diabetic ketoacidosis. Although recent studies showed that metabolic acidosis is associated with high mortality and increased the length of stay in the hospital and ICU (1,2), it remains uncertain whether or not there is a true cause relationship between metabolic acidosis and adverse clinical outcomes.…”

Section: Introductionmentioning

confidence: 99%

Metabolic acidosis as a risk factor for the development of acute kidney injury and hospital mortality

Wang

Geng

et al. 2017

Experimental and Therapeutic Medicine

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Metabolic acidosis has been proved to be a risk factor for the progression of chronic kidney disease, but its relation to acute kidney injury (AKI) has not been investigated. In general, a diagnosis of metabolic acidosis is based on arterial blood gas (ABG) analysis, but the diagnostic role of carbon dioxide combining power (CO2CP) in the venous blood may also be valuable to non-respiratory patients. This retrospective study included all adult non-respiratory patients admitted consecutively to our hospital between October 01, 2014 and September 30, 2015. A total of 71,089 non-respiratory patients were included, and only 4,873 patients were evaluated by ABG analysis at admission. In patients with ABG, acidosis, metabolic acidosis, decreased HCO3− and hypocapnia at admission was associated with the development of AKI, while acidosis and hypocapnia were independent predictors of hospital mortality. Among non-respiratory patients, decreased CO2CP at admission was an independent risk factor for AKI and hospital mortality. ROC curves indicated that CO2CP was a reasonable biomarker to exclude metabolic acidosis, dual and triple acid-base disturbances. The effect sizes of decreased CO2CP on AKI and hospital mortality varied according to age and different underlying diseases. Metabolic acidosis is an independent risk factor for the development of AKI and hospital mortality. In non-respiratory patient, decreased CO2CP is also an independent contributor to AKI and mortality and can be used as an indicator of metabolic acidosis.

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“…The many risk factors that exist at the ICU stage for donors, including hypotension, pulmonary disease, liver failure, sepsis, hypovolemia, heart failure, bleach injection, and many medications (for example, ACE inhibitors, vasopressors, aminoglycosides, and NSAIDs), can lead to development of AKI. [29][30][31][32][33][34] Kidney donors could potentially present with all of these risk factors. It should also be mentioned that AKI is relatively common in patients with traumatic brain injury (TBI), with an incidence of 9.2%.…”

Section: Discussionmentioning

confidence: 99%

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Stolyar

Budkar²,

Solodushkin³

et al. 2015

Exp Clin Transplant

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Objectives: We analyzed different donor characteristics to determine those that significantly affect patient and graft outcomes after kidney transplant. Materials and Methods:We conducted a retrospective analysis of patients who had received kidney transplants at our institution between 1990 and 2011 from deceased-donors. We tracked this patients until the end of 2014. Using univariate and multivariate analyses, we analyzed the following outcomes: patient status, graft status, chronic allograft nephropathy, and delayed graft function. Results: In 342 recipients, univariate analysis revealed donor-associated predictors of transplant outcomes. Recipients of kidneys from older donors showed longer time to creatinine normalization (P = .047). We found a partial correlation between donor diagnosis and the number of dialyses after surgery (excluding the effect of donor age), with patients receiving kidneys from donors who had cerebrovascular events having higher risk of delayed graft function (P = .03). Donors with shorter stays in intensive care units resulted in longer graft survival (P = .02), and vasopressor use by donors was associated with delayed graft function in recipients (P = .018). Low serum sodium levels in donors predicted worse survival of recipients and transplants (P = .015 and P = .048). The number of hemodialysis procedures after transplant was correlated with the donor's creatinine level (P = .027). Insufficient daily dieresis of donor predicted worse graft survival (P = .04). Correlation analysis showed that a higher P CO2 level in donors was significantly associated with longer creatinine normalization time after kidney transplant (P = .001). Cox regression analysis detected 2 significant independent predictors of graft outcomes: duration of perfusion of donor kidney (P = .016) and length of intensive care unit stay of donor (P = .032), with improved prognosis associated with longer perfusion time and shorter time in intensive care unit. Conclusions:The kidney donor has a direct effect on patient life expectancy and renal graft success after transplant.

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Risk factors for death among critically ill patients with acute renal failure

Cited by 38 publications

References 43 publications

Acute kidney injury in critically ill patients with lung disease: kidney-lung crosstalk

Acute kidney injury in critically ill patients with lung disease: kidney-lung crosstalk

Metabolic acidosis as a risk factor for the development of acute kidney injury and hospital mortality

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