Risk of Acute Kidney Injury Associated With Medication Administration in the Emergency Department

Hinson, Jeremiah S.; Ehmann, Michael R.; Jalbout, Nour Al; Ortmann, Melinda J.; Zschoche, Juliana; Klein, Eili Y.

doi:10.1016/j.jemermed.2019.11.034

Cited by 9 publications

(4 citation statements)

References 46 publications

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“…Thirdly, organ damage could originate from a history of medication including nonsteroidal anti-inflammatory drugs, antibiotics, and traditional Chinese medicine which are associated with renal or liver injury. 21,22 In our study, all patients received intravenous of antibiotics and anti-virus drugs.…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics of 82 death cases with COVID-19

Zhang

Zhou

Qiu

et al. 2020

Preprint

229

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Background:A recently developing pneumonia caused by SARS-CoV-2 was originated in Wuhan, China, and has quickly spread across the world. We reported the clinical characteristics of 82 death cases with COVID-19 in a single center. Methods:Clinical data on 82 death cases laboratory-confirmed as SARS-CoV-2 infection were obtained from a Wuhan local hospital's electronic medical records according to previously designed standardized data collection forms.Results: All patients were local residents of Wuhan, and the great proportion of them were diagnosed as severe illness when admitted. Most of the death cases were male (65.9%). More than half of dead patients were older than 60 years (80.5%) and the median age was 72.5 years. The bulk of death cases had comorbidity (76.8%), including hypertension (56.1%), heart disease (20.7%), diabetes (18.3%), cerebrovascular disease (12.2%), and cancer (7.3%). Respiratory failure remained the leading cause of death (69.5%), following by sepsis syndrome/MOF (28.0%), cardiac failure (14.6%), hemorrhage (6.1%), and renal failure (3.7%). Furthermore, respiratory, cardiac, hemorrhage, hepatic, and renal damage were found in 100%, 89%, 80.5%, 78.0%, and 31.7% of patients, respectively. On the admission, lymphopenia (89.2%), neutrophilia (74.3%), and thrombocytopenia (24.3%) were usually observed. Most patients had a high neutrophil-to-lymphocyte ratio of >5 (94.5%), high systemic immune-inflammation index of >500 (89.2%), increased C-reactive protein level (100%), lactate dehydrogenase (93.2%), and D-dimer (97.1%). A high level of IL-6 (>10 pg/ml) was observed in all detected patients.Median time from initial symptom to death was 15 days , and a significant association between aspartate aminotransferase (p=0.002), alanine All rights reserved. No reuse allowed without permission. author/funder, who has granted medRxiv a license to display the preprint in perpetuity. : medRxiv preprint aminotransferase (p=0.037) and time from initial symptom to death were interestingly observed. Conclusion:Older males with comorbidities are more likely to develop severe disease, even die from SARS-CoV-2 infection. Respiratory failure is the main cause of COVID-19, but either virus itself or cytokine release storm mediated damage to other organ including cardiac, renal, hepatic, and hemorrhage should be taken seriously as well.

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Section: Discussionmentioning

confidence: 99%

Clinical characteristics of 82 death cases with COVID-19

Zhang

Zhou

Qiu

et al. 2020

Preprint

229

240

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“…The pooled analysis based on two studies found that ACE inhibitors may not be a significant risk factor for AKI following hip fracture surgery. Actually, many studies found that ACE inhibitors were a significant predictor for AKI [27][28][29]. Also, many risk factors including chronic kidney disease, intraoperative hypotension, and dementia were reported to be significant predictors for AKI, but we did not include them for further pooled analyses owing to the fact that they were reported in the limited studies.…”

Section: Discussionmentioning

confidence: 99%

The prevalence and risk factors of acute kidney injury in patients undergoing hip fracture surgery: a meta-analysis

Wang

et al. 2021

Bioengineered

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Acute kidney injury (AKI) was a frequent complication following hip fracture surgery, but recent studies reported inconsistent findings. Our study was aimed at clarifying the prevalence and risk factors of AKI after hip fracture surgery. Pubmed, Embase, and Web of Science were systematically searched from the inception to March 2020 to identify observational studies investigating the prevalence and risk factors of AKI in patients undergoing hip fracture surgery. Pooled prevalence and odds ratios (ORs) with 95% confidence intervals (CIs) were estimated using a random-effects model. Publication bias was evaluated with a funnel plot and statistical test. All the statistical analyses were performed using Stata version 12.0. A total of 11 studies with 16,421 patients was included in the current meta-analysis. The pooled prevalence of AKI in patients undergoing hip fracture surgery was 17% (95%CI, 14%-21%) with substantial heterogeneity (I 2 = 95%). Postoperative serum albumin (OR 1.80; 95%CI, 1.38-2.36) was a significant predictor for AKI. Age (OR 1.01; 95%CI, 0.95-1.07) and ACE inhibitors (OR 1.38; 95%CI, 0.92-2.07) were associated with increased the risk of AKI, but the results were not statistically significant. No significant publication bias was identified through statistical tests (Egger's test, p = 0.258 and Begg's test, p = 0.087). In conclusion, our findings indicated that the pooled AKI following hip fracture surgery was approximately 17%. Postoperative serum albumin was a potential significant risk factor for AKI.

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“…Second, the consecutive detection of cytokines is lacking, which fails to truly monitor the severity of CRS. Third, organ damage could originate from a history of medication, including nonsteroidal anti-inflammatory drugs, antibiotics, and traditional Chinese medicine, which are associated with renal or liver injury [21,22]. In our study, all patients received intravenous antibiotics and antiviral drugs.…”

Section: Plos Onementioning

confidence: 94%

Clinical characteristics of 82 cases of death from COVID-19

et al. 2020

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A recently developed pneumonia caused by SARS-CoV-2 bursting in Wuhan, China, has quickly spread across the world. We report the clinical characteristics of 82 cases of death from COVID-19 in a single center. Clinical data on 82 death cases laboratory-confirmed as SARS-CoV-2 infection were obtained from a Wuhan local hospital's electronic medical records according to previously designed standardized data collection forms. All patients were local residents of Wuhan, and a large proportion of them were diagnosed with severe illness when admitted. Due to the overwhelming of our system, a total of 14 patients (17.1%) were treated in the ICU, 83% of deaths never received Critical Care Support, only 40% had mechanical ventilation support despite 100% needing oxygen and the leading cause of death being pulmonary. Most of the patients who died were male (65.9%). More than half of the patients who died were older than 60 years (80.5%), and the median age was 72.5 years. The bulk of the patients who died had comorbidities (76.8%), including hypertension (56.1%), heart disease (20.7%), diabetes (18.3%), cerebrovascular disease (12.2%), and cancer (7.3%). Respiratory failure remained the leading cause of death (69.5%), followed by sepsis/MOF (28.0%), cardiac failure (14.6%), hemorrhage (6.1%), and renal failure (3.7%). Furthermore, respiratory, cardiac, hemorrhagic, hepatic, and renal damage were found in 100%, 89%, 80.5%, 78.0%, and 31.7% of patients, respectively. On admission, lymphopenia (89.2%), neutrophilia (74.3%), and thrombocytopenia (24.3%) were usually observed. Most patients had a high neutrophil-to-lymphocyte ratio of >5 (94.5%), high systemic immune-inflammation index of >500 (89.2%), and increased C-reactive protein (100%), lactate dehydrogenase (93.2%), and D-dimer (97.1%) levels. A high level of IL-6 (>10 pg/ml) was observed in all detected patients. The median time from initial symptoms to death was 15 days (IQR 11-20), and a significant association between aspartate aminotransferase (p = 0.002), alanine aminotransferase (p = 0.037) and time from initial symptoms to death was remarkably observed. Older males with comorbidities are more likely to develop severe disease and even die from SARS-CoV-2 infection. Respiratory failure is the main cause of COVID-19, but the virus itself and cytokine release syndrome-mediated damage to other organs, including cardiac, renal, hepatic, and hemorrhagic damage, should be taken seriously as well.

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Risk of Acute Kidney Injury Associated With Medication Administration in the Emergency Department

Cited by 9 publications

References 46 publications

Clinical characteristics of 82 death cases with COVID-19

Clinical characteristics of 82 death cases with COVID-19

The prevalence and risk factors of acute kidney injury in patients undergoing hip fracture surgery: a meta-analysis

Clinical characteristics of 82 cases of death from COVID-19

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