Acute kidney injury in critically ill patients with 2009 influenza A (H1N1) viral pneumonia: an observational study

Nin, Nicolás; Lorente, José A.; Soto, Luis; Ríos, Fernando; Hurtado, Javier; Arancibia, Francisco; Ugarte, Sebastián; Echevarría, E. Martín; Cardinal, Pablo; Saldarini, Fernando; Bagnulo, Homero; Cortés, Irene; Bujedo, G.; Ortega, Carlos; Frutos, Fernando de; Esteban, Andrés

doi:10.1007/s00134-011-2167-7

Cited by 38 publications

(48 citation statements)

References 17 publications

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“…It provides prospective, multicentre, nationally representative data of critically ill patients with pH1N1 and describes the incremental burden associated with development of AKI. Our study also provides complementary data to other large observational studies from distinct geographic regions on the attributable burden of AKI in pH1N1-related critical illness [1,5,23,25]. However, we also recognize our study’s limitations.…”

Section: Discussionmentioning

confidence: 70%

“…Recently, reports have described the incidence and outcomes of AKI among critically ill adult and pediatric pH1N1 patients [13]–[28]. Many studies, however, were limited by design (case reports [14,17,20,22,24,28] or small case series [13,15,18,21,27]), small sample size [16,19,25], or single-center enrollment [13,15,16,18,21]. There have been few larger scale prospective multi-center cohorts [19,23,26], none of which described the Canadian pandemic.…”

Section: Introductionmentioning

confidence: 99%

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Acute kidney injury among critically ill patients with pandemic H1N1 influenza A in Canada: cohort study

et al. 2013

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BackgroundCanada’s pandemic H1N1 influenza A (pH1N1) outbreak led to a high burden of critical illness. Our objective was to describe the incidence of AKI (acute kidney injury) in these patients and risk factors for AKI, renal replacement therapy (RRT), and mortality.MethodsFrom a prospective cohort of critically ill adults with confirmed or probable pH1N1 (16 April 2009–12 April 2010), we abstracted data on demographics, co-morbidities, acute physiology, AKI (defined by RIFLE criteria for Injury or Failure), treatments in the intensive care unit, and clinical outcomes. Univariable and multivariable logistic regression analyses were used to evaluate the associations between clinical characteristics and the outcomes of AKI, RRT, and hospital mortality.ResultsWe included 562 patients with pH1N1-related critical illness (479 [85.2%] confirmed, 83 [14.8%] probable]: mean age 48.0 years, 53.4% female, and 13.3% aboriginal. Common co-morbidities included obesity, diabetes, and chronic obstructive pulmonary disease. AKI occurred in 60.9%, with RIFLE categories of Injury (23.0%) and Failure (37.9%). Independent predictors of AKI included obesity (OR 2.94; 95%CI, 1.75-4.91), chronic kidney disease (OR 4.50; 95%CI, 1.46-13.82), APACHE II score (OR per 1-unit increase 1.06; 95%CI, 1.03-1.09), and PaO2/FiO2 ratio (OR per 10-unit increase 0.98; 95%CI, 0.95-1.00). Of patients with AKI, 24.9% (85/342) received RRT and 25.8% (85/329) died. Independent predictors of RRT were obesity (OR 2.25; 95% CI, 1.14-4.44), day 1 mechanical ventilation (OR 4.09; 95% CI, 1.21-13.84), APACHE II score (OR per 1-unit increase 1.07; 95% CI, 1.03-1.12), and day 1 creatinine (OR per 10 μmol/L increase, 1.06; 95%CI, 1.03-1.10). Development of AKI was not independently associated with hospital mortality.ConclusionThe incidence of AKI and RRT utilization were high among Canadian patients with critical illness due to pH1N1.

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Section: Discussionmentioning

confidence: 70%

Section: Introductionmentioning

confidence: 99%

Acute kidney injury among critically ill patients with pandemic H1N1 influenza A in Canada: cohort study

et al. 2013

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“…Severe sepsis, often complicated by renal hypoperfusion in septic shock, is characterized by a profound inflammatory milieu and associated dysfunction of multiple organ systems. Rates of AKI reported in septic patients range from 13% up to >64.4% [49–51, 87, 108, 109]. The toxic effects of sepsis on AKI do not appear to be specific to bacterial or fungal pathogens.…”

Section: Special Patient Populationsmentioning

confidence: 99%

Epidemiology of Acute Kidney Injury in the Intensive Care Unit

Case

Khan

Khalid

et al. 2013

Critical Care Research and Practice

258

223

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The incidence of acute kidney injury (AKI) in the intensive care unit (ICU) has increased during the past decade due to increased acuity as well as increased recognition. Early epidemiology studies were confounded by erratic definitions of AKI until recent consensus guidelines (RIFLE and AKIN) standardized its definition. This paper discusses the incidence of AKI in the ICU with focuses on specific patient populations. The overall incidence of AKI in ICU patients ranges from 20% to 50% with lower incidence seen in elective surgical patients and higher incidence in sepsis patients. The incidence of contrast-induced AKI is less (11.5%–19% of all admissions) than seen in the ICU population at large. AKI represents a significant risk factor for mortality and can be associated with mortality greater than 50%.

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“…Por ejemplo, un estudio observacional efectuado en 13 unidades intensivas del cono sur de Latinoamérica en la primera ola de la pandemia, detectó una incidencia de 51% de injuria renal aguda y un requerimiento dialítico en 24% de los casos 4 . Esta alta frecuencia contrasta de sobremanera con nuestros propios datos.…”

Section: Discussionunclassified

Glomerulonefritis aguda con requerimiento de diálisis asociada a influenza A H1N1pdm09: Comunicación de dos casos

Aceituno

Fíca

Fasce

et al. 2017

Rev. chil. infectol.

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Acute glomerulonephritis with hemodialysis requirement secondary to influenza A H1N1pdm09 infection. Report of two cases Acute renal failure (ARF) requiring hemodialysis is not common among patients affected by influenza. We report two unvaccinated adult patients with smoking habit, which were admitted with severe influenza A H1N1pdm09 that evolved with shock and required mechanical ventilation. Both patients developed progressive renal failure with oliguria/anuria, associated with urinary of inflammatory sediment with proteinuria, microhematuria and in one case also with hypocomplementemia, suggesting acute glomerulonephritis. Renal replacement therapy (RRT) was required in both cases. In one patient, who died of late complications, sequencing of the HA1 segment revealed the previously described D222N mutation associated to severe cases. ARF with RRT appears to be an uncommon complication of patients hospitalized for influenza A H1N1pdm09 and may be secondary to acute glomerulonephritis.

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Acute kidney injury in critically ill patients with 2009 influenza A (H1N1) viral pneumonia: an observational study

Abstract: AKI is a frequent complication of 2009 influenza A (H1N1) viral pneumonia. AKI developing after 2 days in ICU appears to be associated with different risk factors than early AKI, and is related to a higher mortality rate.

Cited by 38 publications

References 17 publications

Acute kidney injury among critically ill patients with pandemic H1N1 influenza A in Canada: cohort study

Acute kidney injury among critically ill patients with pandemic H1N1 influenza A in Canada: cohort study

Epidemiology of Acute Kidney Injury in the Intensive Care Unit

Glomerulonefritis aguda con requerimiento de diálisis asociada a influenza A H1N1pdm09: Comunicación de dos casos

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