Risk Factors and Outcomes Associated With the Development of Persistent Acute Kidney Injury in Non-Renal Solid Organ Transplant Recipients: Systematic Review and Meta-Analysis.

Autor: Saraiva IE; Department of Critical Care Medicine, Center for Critical Care Nephrology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA., Hamahata N; Department of Critical Care Medicine, Center for Critical Care Nephrology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA., Sakhuja A; Department of Medicine and Institute for Critical Care Medicine, Icahn School of Medicine, Mount Sinai, New York, New York, USA., Chen X; Department of Biostatistics, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA., Minturn JS; Department of Critical Care Medicine, The CRISMA Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA., Sanchez PG; Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA., Chan EG; Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA., Kaczorowski DJ; Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA., Al-Khafaji A; Department of Critical Care Medicine, Center for Critical Care Nephrology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.; Department of Critical Care Medicine, The CRISMA Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA., Kellum JA; Department of Critical Care Medicine, Center for Critical Care Nephrology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.; Department of Critical Care Medicine, The CRISMA Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA., Gómez H; Department of Critical Care Medicine, Center for Critical Care Nephrology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.; Department of Critical Care Medicine, The CRISMA Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Jazyk: angličtina
Zdroj: Clinical transplantation [Clin Transplant] 2024 Sep; Vol. 38 (9), pp. e15444.
DOI: 10.1111/ctr.15444
Abstrakt: Persistent acute kidney injury (pAKI), compared with acute kidney injury (AKI) that resolves in <72 h, is associated with worse prognosis in critically ill patients. Definitions and prognosis of pAKI are not well characterized in solid organ transplant patients. Our aims were to investigate (a) definitions and incidence of pAKI; (b) association with clinical outcomes; and (c) risk factors for pAKI among heart, lung, and liver transplant recipients. We systematically reviewed the literature including PubMed, Embase, Web of Science, and Cochrane from inception to 8/1/2023 for human prospective and retrospective studies reporting on the development of pAKI in heart, lung, or liver transplant recipients. We assessed heterogeneity using Cochran's Q and I 2 . We identified 25 studies including 6330 patients. AKI (8%-71.6%) and pAKI (2.7%-55.1%) varied widely. Definitions of pAKI included 48-72 h (six studies), 7 days (three studies), 14 days (four studies), or more (12 studies). Risk factors included age, body mass index (BMI), diabetes, preoperative chronic kidney disease (CKD), intraoperative vasopressor use, and intraoperative circulatory support. pAKI was associated with new onset of CKD (odds ratio [OR] 1.41-11.2), graft dysfunction (OR 1.81-8.51), and long-term mortality (OR 3.01-13.96), although significant heterogeneity limited certainty of CKD and graft dysfunction outcome analyses. pAKI is common and is associated with worse mortality among liver and lung transplant recipients. Standardization of the nomenclature of AKI will be important in future studies (PROSPERO CRD42022371952).
(© 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
Externí odkaz: