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Utilizing reclassification to explore characteristics and prognosis of KDIGO(SCr) AKI subgroups: a retrospective analysis of a multicenter prospective cohort study

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机构: [a]Medical Intensive Care Unit, Peking Union Medical College Hospital, Beijing, China [b]Trauma Intensive Care Unit, Peking UniversityPeople’s Hospital, Key Laboratory of Trauma and Neural Regeneration (Peking University) Ministry of Education, Beijing, China [c]Department of Critical Care Medicine, Tsinghua changgung Hospital, Beijing, China [d]Department of Critical Care Medicine, PekingUniversity People’s Hospital, Beijing, China [e]Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu,China [f]Department of Critical Care Medicine, First Affiliated Hospital, Xinjiang Medical University, Urumqi, China [g]Department ofCritical Care Medicine, The First Affiliated Hospital, Harbin Medical University, Harbin, China [h]Department of Critical Care Medicine,The First Affiliated Hospital of China Medical University, Shenyang, China [i]Department of Critical Care Medicine, Xiangya Hospital,Central South University, Changsha, China [j]Department of Critical Care Medicine, Beijing Tongren Hospital, Capital Medical University,Beijing, China [k]Department of Critical Care Medicine, Fuxing Hospital, Capital Medical University, Beijing, China [l]Department ofEmergency Medicine, The First Affiliated Hospital of Kunming Medical College, Kunming, China [m]Department of Critical CareMedicine, Qilu Hospital, Shandong University, Jinan, China [n]Department of Critical Care Medicine, Zhejiang Provincial People’sHospital, Hangzhou, China [o]Department of Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University ofScience & Technology, Wuhan, China [p]Department of Critical Care Medicine, Hebei Medical University Fourth Hospital, Shijiazhuang,China [q]Department of Critical Care Medicine, Affiliated Hospital of Ningxia Medical University, Yinchuan, China [r]Department ofCritical Care Medicine, The First Affiliated Hospital, Chongqing Medical University, Chongqing, China [s]Department of Critical CareMedicine, Xuanwu Hospital, Capital Medical University, Beijing, China [t]Department of Critical Care Medicine, The First AffiliatedHospital of Fujian Medical University, Fuzhou, China [u]Department of Emergency Medicine, Ruijin Hospital, Shanghai Jiao TongUniversity, Shanghai, China [v]Department of Critical Care Medicine, Guangdong General Hospital, Guangzhou, China [w]Department ofCritical Care Medicine, Hainan Provincial People’s Hospital, Haikou, China [x]Department of Emergency Medicine, Peking UniversityPeople’s Hospital, Beijing, China
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关键词: Acute kidney injury KDIGO intensive care unit mortality length of stay

摘要:
Background Acute kidney injury (AKI) is widespread in the intensive care unit (ICU) and affects patient prognosis. According to Kidney Disease: Improving Global Outcomes (KDIGO) guidelines, the absolute and relative increases of serum creatinine (Scr) are classified into the same stage. Whether the prognosis of the two types of patients is similar in the ICU remains unclear. Methods According to the absolute and relative increase of Scr, AKI stage 1 and stage 3 patients were divided into stage 1a and 1b, stage 3a and 3b groups, respectively. Their demographics, laboratory results, clinical characteristics, and outcomes were analyzed retrospectively. Results Of the 345 eligible cases, we analyzed stage 1 because stage 3a group had only one patient. Using 53 or 61.88 mu mol/L as the reference Scr (Scr(ref)), no significant differences were observed in ICU mortality (P-53 =0.076, P-61.88 =0.070) or renal replacement therapy (RRT) ratio, (P-53 =0.356, P-61.88 =0.471) between stage 1a and 1b, but stage 1b had longer ICU length of stay (LOS) than stage 1a (P-53 <0.001, P-61.88 =0.032). In the Kaplan-Meier survival analysis, no differences were observed in ICU mortality between stage 1a and 1b (P-53 =0.378, P-61.88 =0.255). In a multivariate analysis, respiratory failure [HR = 4.462 (95% CI 1.144-17.401), p = 0.031] and vasoactive drug therapy [HR = 4.023 (95% CI 1.584-10.216), p = 0.003] were found to be independently associated with increased risk of death. Conclusion ICU LOS benefit was more prominent in KDIGO(SCr) AKI stage 1a patients than in stage 1 b. Further prospective studies with a larger sample size are necessary to confirm the effectiveness of reclassification.

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基金编号: 2020YFC0841300

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出版当年[2022]版:
大类 | 3 区 医学
小类 | 3 区 泌尿学与肾脏学
最新[2023]版:
大类 | 3 区 医学
小类 | 3 区 泌尿学与肾脏学
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出版当年[2021]版:
Q2 UROLOGY & NEPHROLOGY
最新[2023]版:
Q1 UROLOGY & NEPHROLOGY

影响因子: 最新[2023版] 最新五年平均 出版当年[2021版] 出版当年五年平均 出版前一年[2020版] 出版后一年[2022版]

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第一作者机构: [a]Medical Intensive Care Unit, Peking Union Medical College Hospital, Beijing, China [b]Trauma Intensive Care Unit, Peking UniversityPeople’s Hospital, Key Laboratory of Trauma and Neural Regeneration (Peking University) Ministry of Education, Beijing, China
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通讯机构: [a]Medical Intensive Care Unit, Peking Union Medical College Hospital, Beijing, China [*1]Medical Intensive Care Unit, Peking Union Medical College Hospital, 1 Shuai Fu Yuan, Beijing, 100730, China.
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