Factors associated with mortality in a population with acute kidney injury undergoing hemodialysis in Peru

Herrera‐Añazco, Percy; Taype-Rondán, Álvaro; Pacheco‐Mendoza, Josmel; Miranda, J. Jaime

doi:10.5935/0101-2800.20170029

Cited by 9 publications

(15 citation statements)

References 2 publications

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“…A study of high-risk surgical patients showed that the customized maintenance of blood pressure according to the patient's previous levels during surgery was able to reduce organ dysfunction [22]. Moreover, the association between the use of vasoactive drugs and mortality is consistent with the results of other studies [23][24][25].…”

Section: Discussionsupporting

confidence: 73%

WITHDRAWN: Role of Acute Kidney Injury in High-Risk Surgical Patients. A Multicenter Prospective Cohort Study.

Katayama¹,

Gomes²,

Lobo³

et al. 2020

Preprint

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Background: Patients who develop postoperative acute kidney injury (AKI) have a poor prognosis, especially when undergoing high-risk surgery. Therefore, the objective of this study was to evaluate the outcome of patients with AKI acquired after noncardiac surgery and the possible risk factors for this complication. Methods: A multicenter, prospective cohort study with patients admitted to intensive care units (ICUs) after noncardiac surgery was conducted to assess whether they developed AKI. The outcomes of patients who developed AKI were then compared to those of patients who did not develop it. Results: A total of 29 ICUs participated, of which 904 involved high-risk surgical patients who were included in the study. The occurrence of AKI in the postoperative period was 15.8%, and the mortality rate of postoperative AKI patients at 28 days was 27.6%. AKI was strongly associated with 28-day mortality (OR = 2.91; 95% CI 1.51-5.62; P= 0.001), and higher length of ICU stay (P< 0.001), length of hospital stay (P<0.001) and length of mechanical ventilator stay (P<0.001). Independent factors for the risk of developing AKI were preoperative anemia (OR=7.0; P= 0.001), SAPS 3 ( OR= 1.04, P<0.001), postoperative vasopressor use (OR= 2.47; P<0.001), postoperative infection (OR= 8.8; P<0.001), need for reoperation (OR= 7.1; P<0.001) and elective surgery (OR= 0.4; P<0.001) was protective for AKI. In addition, patients with higher perioperative fluid balance had more chance for AKI.Conclusions: AKI is associated with risk of death. Patients with anemia prior to surgery, who had a higher SAPS 3, needed a postoperative vasopressor or had postoperative infection or needed reoperation were more likely to develop AKI, as were those with a higher perioperative fluid balance.

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Section: Discussionsupporting

confidence: 73%

WITHDRAWN: Role of Acute Kidney Injury in High-Risk Surgical Patients. A Multicenter Prospective Cohort Study.

Katayama¹,

Gomes²,

Lobo³

et al. 2020

Preprint

View full text Add to dashboard Cite

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“…It also seems to predict hospital readmission in individuals discharged of ICU and is associated with a higher probability of death 30 days after discharge 30 . Nevertheless, other studies demonstrated that AKI is not associated with mortality in subjects admitted in ICU and higher creatinine levels are associated with lower mortality rates in hemodialytic patients 31,32 . This study did not observe any associations between mortality and AKI.…”

Section: Discussionmentioning

confidence: 95%

Mortality prognostic factors associated with SAPS 3 and APACHE II in elderly patients admitted in intensive care unit

Lucena¹,

Santos-Veloso²,

Xavier³

et al. 2019

Medicina (Ribeirao Preto Online)

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Study design: a descriptive, prospective cohort study. Objectives: identify the risk factors associated with SAPS 3 and APACHE II score to improve mortality prediction in elderly admitted in the intensive care unit (ICU). Methodology: a cohort study with 174 elderly patients admitted in ICU from July 2016 to June 2017. The primary independent variables analyzed were: presence of stress hyperglycemia, the need for invasive mechanical ventilation (IMV), acute renal failure, level of consciousness and use of vasopressors. The outcomes studied were death and hospital discharge. Results: ICU and hospital mortality were 17.8% and 29.8%, respectively. The multivariate analysis of factors associated with hospital death not contemplated in the obtaining of SAPS 3 demonstrated that IMV, Chronic Obstructive Pulmonary Disease (COPD) and Mean Arterial Pressure (MAP) <70 mmHg improved the prediction of mortality. The Hosmer-Lemeshow test (p=0.472) and area under ROC curve=0.80 (CI95%:0.731-0.872) confirmed, respectively, an appropriate calibration and acceptable-to-excellent discriminatory power for this model. IMV and COPD were also factors associated with the APACHE II score in prediction of mortality with appropriated calibration (p=0.471) and acceptable-to-excellent discriminatory power (area under ROC curve=0.80 [CI95%:0.730-0.868]). Conclusion: IMV, COPD, and MAP <70 mmHg were associated with SAPS3 and APACHE II to predict mortality in elderly admitted to ICU.

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“…A manutenção criteriosa da estabilidade cardiovascular, incluindo a infusão de líquidos, durante todo esse período, é vital para proteger a perfusão renal, evitando a sobrecarga de volume. Um estudo em pacientes cirúrgicos de alto risco demonstrou que a manutenção da pressão arterial, personalizada, de acordo com os níveis prévios do paciente durante a cirurgia foi capaz de diminuir disfunções orgânicas 19 . Nossos resultados sugerem que o uso de drogas vasoativas, provavelmente relacionados a algum período de hipotensão, também é associado a maior mortalidade.…”

Section: Resultsunclassified

Lesão renal aguda após cirurgias não cardíacas: incidência e impacto das disfunções orgânicas extra-renais nos desfechos

Goiato¹,

Gandolfi

Cavallari³

et al. 2019

ACS

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Introdução: A permanência de pacientes em Unidades de Terapia Intensiva (UTI) é frequentemente complicada por Lesão Renal Aguda (LRA), principalmente em casos de sepse, baixo débito cardíaco e pós-operatório de grandes cirurgias. Objetivo: Avaliar a incidência, características, desenvolvimento de outras disfunções orgânicas, e desfechos de pacientes com LRA adquirida na UTI após cirurgias não cardíacas. Métodos: Estudo de coorte, prospectivo. Todos os pacientes internados consecutivamente nas UTIs após cirurgias não cardíacas nos meses de abril e maio de 2017 foram analisados quanto ao desenvolvimento ou não de LRA, de outras disfunções orgânicas e ao balanço hídrico. Resultados: A incidência de LRA foi de 16,2%. Os pacientes que desenvolveram LRA no pós-operatório eram mais graves, e diferiram quanto à necessidade de ventilação mecânica (60% vs. 11%, p < 0,001), uso de drogas vasoativas (82% vs. 44%, p = 0,021); presença de infecção (80% vs. 21%, p < 0,001), sepse ou choque séptico (50% vs. 9%, p < 0,001) e a outras complicações pós-operatórias (91% vs. 58%, p = 0,023). Outras disfunções de órgãos e sistemas foram mais fre-quentes nos pacientes com IRA (2 [2-3] vs. 1 [0-1], p < 0,001), particularmente disfunção gas-trointestinal (73% vs. 19%, p < 0,001) e cardiovascular (73% vs. 33%, p = 0,015). O número de pacientes com duas ou mais disfunções orgânicas aumentou de 21% para 82% em pacientes com LRA (RR 3,89, IC: 2,18 – 6,90, p < 0,001). O tempo de internação (13 ± 9 vs. 5 ± 6 dias, p < 0,001) e a mortalidade hospitalar (54,5% vs. 7%, p = 0,013) foram maiores nos pacientes com LRA. Conclusão: Entre pacientes com cirurgias não cardíacas e necessidade de UTI, a incidência de LRA é elevada e associada a complicações de outros sistemas, incluindo os sistemas neurológico, gastrointestinal, respiratório e cardiovascular; somandose a isso, balanço hídrico acumulado positivo, sepse e choque, maior tempo de internação e maiores taxas de mortalidade também foram encontrados nesses pacientes. Palavras-Chave: Lesão Renal Aguda; Unidades de Terapia Intensiva; Epidemiologia; Fatores de Risco; Período Perioperatório.

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Factors associated with mortality in a population with acute kidney injury undergoing hemodialysis in Peru

Abstract: Four out of every ten AKI patients undergoing HD die. Higher levels of creatinine were associated with lower probability of mortality.

Cited by 9 publications

References 2 publications

WITHDRAWN: Role of Acute Kidney Injury in High-Risk Surgical Patients. A Multicenter Prospective Cohort Study.

WITHDRAWN: Role of Acute Kidney Injury in High-Risk Surgical Patients. A Multicenter Prospective Cohort Study.

Mortality prognostic factors associated with SAPS 3 and APACHE II in elderly patients admitted in intensive care unit

Lesão renal aguda após cirurgias não cardíacas: incidência e impacto das disfunções orgânicas extra-renais nos desfechos

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