Dysnatremias in emergency patients with acute kidney injury: A cross-sectional analysis

Woitok, Bertram K.; Funk, Georg‐Christian; Walter, Philipp; Schwarz, Christoph; Ravioli, Svenja; Lindner, Gregor

doi:10.1016/j.ajem.2020.01.009

Cited by 20 publications

(23 citation statements)

References 24 publications

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“…Our results were consistent with previous studies, reporting that first SCr value or assumed eGFR of 75 mL/min per 1.73 m 2 , in exchange of reduced selection bias and feasibility, may lead to misclassification in AKI diagnosis and staging [12, 19, 20]. These limitations have been recognized; nevertheless, the use of the surrogates is still widespread in AKI research [21-25]. In our patients, the eGFR 75 method overestimated disease incidence (19.3 vs. 14.…”

Section: Discussionsupporting

confidence: 90%

Estimation of Missing Baseline Serum Creatinine for Acute Kidney Injury Diagnosis in Hospitalized Patients

Laszczyńska

Severo

Correia

et al. 2020

Nephron

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Introduction: In hospitalized patients, information on preadmission kidney function is often missing, impeding timely and accurate acute kidney injury (AKI) detection and affecting results of AKI-related studies. Objective: In this study, we provided estimates of preadmission serum creatinine (SCr), based on a multivariate linear regression (Model 1) and random forest model (Model 2) built with different parametrizations. Their accuracy for AKI diagnosis was compared with the accuracy of commonly used surrogate methods: (i) SCr at hospital admission (first SCr) and (ii) SCr back-calculated from the assumed estimated glomerular filtration rate of 75 mL/min/1.73 m2 (eGFR 75). Methods: From 44,670 unique adult admissions to a tertiary referral centre between 2013 and 2015, we analysed 8,540 patients with preadmission SCr available. To control for differences in characteristics of patients with and without SCr, we used an inverse probability weighting technique. Results: Estimates of SCr were likely to be higher than true preadmission SCr in a low Cr concentration and undervalued in high concentrations although for Model 2 Complete-SCr these differences were smallest. The true cumulative incidence of AKI was 14.8%. Model 2 Complete-SCr had the best agreement for AKI diagnosis (kappa 0.811, 95% CI 0.787–0.835), while surrogate methods resulted in the lowest agreement: (kappa 0.553, 0.516–0.590) and (0.648, 0.620–0.676) for first SCr and eGFR 75, respectively. Conclusions: Multivariable imputation of preadmission SCr, taking into account elementary admission data, improved accuracy in AKI diagnosis over commonly used surrogate methods. Random forest-based models can serve as an effective tool in research.

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Section: Discussionsupporting

confidence: 90%

Estimation of Missing Baseline Serum Creatinine for Acute Kidney Injury Diagnosis in Hospitalized Patients

Laszczyńska

Severo

Correia

et al. 2020

Nephron

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“…Loop diuretics have in fact been identified as an independent risk factor for hypernatraemia in some studies. 23,24 In the light of this, our findings of ongoing use of furosemide offering a moderate protection against severe hyponatraemia (aOR: 0.52) are perhaps not surprising. Similar effects have been observed…”

Section: Discussionmentioning

confidence: 82%

Non‐thiazide diuretics and hospitalization due to hyponatraemia: A population‐based case‐control study

Mannheimer

Falhammar

Calissendorff

et al. 2021

Clinical Endocrinology

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“…In 2020, Woitok et al [ 24 ] published a cross-sectional study which analyzed data from a 2-year period (January 2017 until December 2018). Subjects admitted to the emergency department were screened for AKI risk factors, particularly for dysnatremias and subsequent outcome variables.…”

Section: Methodsmentioning

confidence: 99%

Stratification of Acute Kidney Injury Risk, Disease Severity, and Outcomes by Electrolyte Disturbances

et al. 2023

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Acute kidney injury (AKI) affects up to 30% of all hospitalized patients in Central Europe and the USA. New biomarker molecules have been identified in recent years; most studies performed so far however aimed to identify markers for diagnostic purposes. Serum electrolytes such as sodium and potassium are quantified in more or less all hospitalized patients. Aim of the article is to review the literature on the AKI predictive role of four distinct serum electrolytes in evolving/progressing AKI. The following databases were searched for references: PubMed, Web of Science, Cochrane Library, and Scopus. The period lasted from 2010 until 2022. The following terms were utilized: "AKI" AND "sodium" OR "potassium" OR "calcium" OR "phosphate" AND "risk" OR "dialysis" OR "recovery of kidney function" OR "renal recovery" OR "kidney recovery" OR "outcome". Finally, 17 references were selected. The included studies were mostly retrospective in nature. Particularly, hyponatremia has been shown to be associated with an overall poor clinical outcome. The association between dysnatremia and AKI is anything but consistent. Hyperkalemia and potassium variability are most likely AKI predictive. Serum calcium and AKI risk are associated in a Ushaped manner. Higher phosphate levels potentially predict AKI in non-coronavirus disease 2019 (COVID-19) patients. The literature suggests that admission electrolytes can offer valuable information about AKI onset during follow-up. Limited data are however available on follow-up characteristics such as the need for dialysis or the chance of renal recovery. These aspects are of particular interest from the nephrologist's perspective.

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Dysnatremias in emergency patients with acute kidney injury: A cross-sectional analysis

Cited by 20 publications

References 24 publications

Estimation of Missing Baseline Serum Creatinine for Acute Kidney Injury Diagnosis in Hospitalized Patients

Estimation of Missing Baseline Serum Creatinine for Acute Kidney Injury Diagnosis in Hospitalized Patients

Non‐thiazide diuretics and hospitalization due to hyponatraemia: A population‐based case‐control study

Stratification of Acute Kidney Injury Risk, Disease Severity, and Outcomes by Electrolyte Disturbances

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