Anaemia is not a risk factor for progression of acute kidney injury:A retrospective analysis
| Autor: | Mario Raimundo, Jonah Powell-Tuck, Luigi Camporota, Siobhan Crichton, Marlies Ostermann, Duncan Wyncoll |
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| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Organ Dysfunction Scores Anemia 030232 urology & nephrology Cardiac index Anaemia 030204 cardiovascular system & hematology Critical Care and Intensive Care Medicine Logistic regression urologic and male genital diseases 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine Severity of illness medicine Humans Hospital Mortality Risk factor Intensive care medicine Aged Retrospective Studies Aged 80 and over Receiver operating characteristic urogenital system business.industry Research Hemodynamics Acute kidney injury Retrospective cohort study Acute Kidney Injury Middle Aged Renal recovery medicine.disease female genital diseases and pregnancy complications Intensive Care Units Disease Progression Regression Analysis Female Haemoglobin business |
| Zdroj: | Powell-Tuck, J, Crichton, S, Raimundo, M, Camporota, L, Wyncoll, D & Ostermann, M 2016, ' Anaemia is not a risk factor for progression of acute kidney injury : A retrospective analysis ', CRITICAL CARE, vol. 20, no. 1, 52 . https://doi.org/10.1186/s13054-016-1231-7 Critical Care |
| Popis: | Background In hospitalised patients, anaemia increases the risk of developing acute kidney injury (AKI). Our aim was to determine whether anaemia also has an impact on the risk of progression from early AKI to more severe AKI in critically ill patients. Methods We retrospectively analysed the data of patients admitted to the adult intensive care unit between 2007 and 2009 who had AKI I as per the AKI Network classification, and who had undergone haemodynamic monitoring within 12 h of AKI I. We collected baseline characteristics, severity of illness, haemoglobin (Hb), and haemodynamic parameters in the first 12 h of AKI I and differentiated between patients who progressed to AKI III and those who did not. Univariate and multivariate logistic regression analyses were used to identify risk factors for progression. Associations between Hb, arterial oxygen saturation and cardiac index were explored by receiver operating characteristic curve analysis. Results Two hundred and ten patients (median age 70 years, 68 % male) underwent haemodynamic monitoring within 12 h of AKI I; 85 (41.5 %) progressed to AKI III. The proportion of patients with underlying cardiac disease was significantly higher among progressors versus non-progressors (58 % vs 34 %, respectively; p = 0.001). On the first day of AKI I, progressors had a significantly higher Sequential Organ Failure Assessment score (9 vs 8; p 2; p p p = 0.02), lower mean arterial blood pressure (median 71 vs 74 mmHg; p = 0.01) and significantly higher requirement for cardiovascular and respiratory support, but there was no difference in Hb concentration (median 96 g/L in both groups). Multivariable regression analysis showed that heart disease, need for mechanical ventilation, arterial lactate, Sequential Organ Failure Assessment score, central venous pressure and cardiac index on first day of AKI I were independently associated with progression to AKI III. There was no significant difference in the risk of progression between patients with Hb ≤ or >80 g/L, and ≤ or >100 g/L on day of AKI I. Conclusions In critically ill patients with AKI stage 1, anaemia was not associated with an increased risk of progression to more severe AKI. |
| Databáze: | OpenAIRE |
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