Risk of developing severe sepsis after acute kidney injury: a population-based cohort study

Lai, Tai‐Shuan; Chen, Ming-Fong; Pan, Sung‐Ching; Huang, Tao‐Min; Lin, Meng-Chun; Lai, Chun‐Fu; Wu, Che‐Hsiung; Wu, Vin‐Cent; Chien, Kuo–Liong

doi:10.1186/cc13054

Cited by 78 publications

(60 citation statements)

References 33 publications

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“…Sepsis is a pathological process involving the excessive cells and humoral immunity caused by infection with bacteria and toxins. A large number of soluble inflammatory factors are involved in MODS (Lai et al, 2013).…”

Section: Discussionmentioning

confidence: 99%

Disease indicators for sepsis and analysis of sepsis treatment in children using the continuous blood purification technique

2015

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Section: Discussionmentioning

confidence: 99%

Disease indicators for sepsis and analysis of sepsis treatment in children using the continuous blood purification technique

2015

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“…The NHI database is one of the largest and most comprehensive databases in the world, and offers research data for various studies on diagnoses, medication use, and hospitalizations [16, 17]. …”

Section: Methodsmentioning

confidence: 99%

Ketoanalogues supplementation decreases dialysis and mortality risk in patients with anemic advanced chronic kidney disease

Yang

Hung

et al. 2017

PLoS ONE

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BackgroundThe benefit of alpha-Ketoanalogues (KA) supplementation for chronic kidney disease (CKD) patients that followed low-protein diet (LPD) remains undetermined.MethodsWe extracted longitudinal data for all CKD patients in the Taiwan National Health Insurance from January 1, 2000 through December 31, 2010. A total of 1483 patients with anemic advanced CKD treated with LPD, who started KA supplementation, were enrolled in this study. We analyzed the risks of end stage renal disease and all-cause mortality using Cox proportional hazard models with influential drugs as time-dependent variables.ResultsA total of 1113 events of initiating long-term dialysis and 1228 events of the composite outcome of long-term dialysis or death occurred in patients with advanced CKD after a mean follow-up of 1.57 years. Data analysis suggests KA supplementation is associated with a lower risk for long-term dialysis and the composite outcome when daily dosage is more than 5.5 tablets. The beneficial effect was consistent in subgroup analysis, independent of age, sex, and comorbidities.ConclusionsAmong advanced CKD patients that followed LPD, KA supplementation at an appropriate dosage may substantially reduce the risk of initiating long-term dialysis or of developing the composite outcome. KA supplementation represents an additional therapeutic strategy to slow the progression of CKD.

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“…Taking into consideration the higher risk of developing CKD or ESRD after AKI and the strong correlations of CKD/ESRD with UGIB and mortality, we used a Cox proportional hazards model with CKD/ESRD as time-dependent covariates (15,25,26), denoted by time-varying CKD/ESRD, to account for the effects of CKD/ESRD developing at some time during follow-up on the risks of UGIB and mortality. Comorbidities and postdischarge medications (use versus nonuse) were also incorporated into the analysis.…”

Section: Statistical Analysesmentioning

confidence: 99%

Long-Term Risk of Upper Gastrointestinal Hemorrhage after Advanced AKI

Lin

et al. 2015

Clinical Journal of the American Society of Nephrology

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Background and objectives There are few reports on temporary dialysis-requiring AKI as a risk factor for future upper gastrointestinal bleeding (UGIB). This study sought to explore the long-term association between dialysisrequiring AKI and UGIB.Design, setting, participants, & measurements This nationwide cohort study used data from the Taiwan National Health Insurance Research Database. Patients who recovered from dialysis-requiring AKI and matched controls were selected from hospitalized patients age $18 years between 1998 and 2006. The cumulative incidences of long-term de novo UGIB were calculated, and the risk factors of UGIB and mortality were identified using timevarying Cox proportional hazard models adjusted for subsequent CKD and ESRD after AKI.Results A total of 4565 AKI-recovery patients and the same number of matched patients without AKI were analyzed. After a median follow-up time of 2.33 years (interquartile range, 0.97-4.81 years), the incidence rates of UGIB were 50 (by stringent criterion) and 69 (by lenient criterion) per 1000 patient-years in the AKI-recovery group and 31 (by stringent criterion) and 48 (by lenient criterion) per 1000 patient-years in the non-AKI group (both P,0.001). When compared with patients in the non-AKI group, the multivariate hazard ratio (HR) for UGIB was 1.30 (95% confidence interval [95% CI], 1.14 to 1.48) for dialysis-requiring AKI, 1.83 (95% CI, 1.53 to 2.20) for time-varying CKD, and 2.31 (95% CI, 1.92 to 2.79) for time-varying ESRD (all P,0.001). Finally, the risk for long-term mortality increased after UGIB (HR, 1.24; 95% CI, 1.12 to 1.38) and dialysis-requiring AKI (HR, 1.66; 95% CI, 1.54 to 1.78).Conclusions Recovery from dialysis-requiring AKI was associated with future UGIB and mortality.

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Risk of developing severe sepsis after acute kidney injury: a population-based cohort study

Cited by 78 publications

References 33 publications

Disease indicators for sepsis and analysis of sepsis treatment in children using the continuous blood purification technique

Disease indicators for sepsis and analysis of sepsis treatment in children using the continuous blood purification technique

Ketoanalogues supplementation decreases dialysis and mortality risk in patients with anemic advanced chronic kidney disease

Long-Term Risk of Upper Gastrointestinal Hemorrhage after Advanced AKI

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