Incidence, Risk Factors, and Outcome of Acute Kidney Injury in Neurocritical Care

Büttner, Stefan; Stadler, Andrea; Mayer, Christoph; Patyna, Sammy; Betz, Christoph; Senft, Christian; Geiger, Helmut; Jung, Ok‐Sang; Finkelmeier, Fabian

doi:10.1177/0885066617748596

Cited by 30 publications

(32 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…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

View full text Add to dashboard Cite

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.

show abstract

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

View full text Add to dashboard Cite

show abstract

“…AKI during hospitalization after major surgical procedures is a risk factor for short-term mortality. Although several studies have reported a higher prevalence of AKI in various patient populations underwent various surgeries and confirmed the association of less severe AKI with short-term mortality, few studies have focused on AKI in the cohort of neurosurgical patients [9]. An unfavorable prognosis is often linked with neurocritical disease.…”

Section: Discussionmentioning

confidence: 99%

Acute kidney injury after prolonged neurosurgical operations

Wahba

Mohamed

Khayat

et al. 2021

Egyptian Journal of Anaesthesia

View full text Add to dashboard Cite

Background: Acute kidney injury (AKI) is a serious condition that causes significant morbidity and mortality in medical and surgical intensive care units. In this environment, the prevalence, risk factors, and prognostic effects of this harmful disorder are well known. But there is paucity about this issue among patients with neurosurgeries. So, this work tried to detect different risk factors for the development of AKI among patients underwent prolonged neurosurgeries. Methods: Over a two-year duration, 100 patients were recruited in the current study. Those patients were eligible for different neurosurgeries. Baseline data including demographic and laboratory in addition to perioperative data were gathered. The main end point was the development of AKI based on the Kidney Disease Improving Global Outcomes criteria Results: Fifteen (15%) patients developed AKI; 13 (86.7%) patients had stage I; and 2 (13.3%) patients had stage II AKI. It was found that risk factors for the development of AKI were old age, operative blood loss, and operative transfusion of mannitol. Only two patients were died, and both of them developed AKI. Conclusion: AKI is a serious complication in patients underwent prolonged neurosurgeries. It has a great effect on patient's prognosis. Early detection of different risk factors for AKI may help in new lines of therapy for those patients with subsequent improvement in their outcome.

show abstract

“…AKI after TBI has been reported developing in 7.6% to 23% patients and is correlated with mortality, functional outcome and length of hospital stay in TBI patients [4][5][6][7]. Mechanisms involved in development of AKI after TBI are diversified, which included systemic inflammation response, neuroendocrine hormone release, hypoperfusion and iatrogenic factors such as blood transfusion, drugs reducing intracranial pressure and usage of nephrotoxic antibiotics [8][9][10][11]. In view of the unfavorable outcome caused by AKI, exploring novel and available biomarkers to predict the possible occurrence of AKI in early stage and consequently avoid medical treatments adverse to normal renal function is beneficial for outcome and recovery of TBI patients.…”

Section: Introductionmentioning

confidence: 99%

A nomogram based on serum cystatin C for predicting acute kidney injury in patients with traumatic brain injury

Wang

Gui

et al. 2021

Renal Failure

View full text Add to dashboard Cite

Background Acute kidney injury (AKI) is a common complication in traumatic brain injury (TBI) patients and is associated with unfavorable outcome of these patients. We designed this study to explore the value of serum cystatin C, an indicator of renal function, on predicting AKI after suffering TBI. Methods Patients confirmed with TBI and hospitalized in the West China Hospital of Sichuan University between January 2015 and December 2019 were included. Patients were divided into two groups according to occurrence of AKI. Univariate and multivariate logistic regression analyses were sequentially utilized to find risk factors of AKI in included TBI patients. Nomogram composed of discovered risk factors for predicting AKI was constructed. Receiver operating characteristics (ROC) curves were drawn and area under the ROC curve (AUC) were calculated to evaluate the predictive value of cystatin C alone and the constructed nomogram. Results Among 234 included TBI patients, 55 were divided into AKI group. AKI group had shorter length of stay ( p < 0.001) and higher in-hospital mortality ( p < 0.001). Multivariate logistic regression analysis showed absolute lymphocyte count ( p = 0.034), serum creatinine ( p < 0.001), serum cystatin C ( p = 0.017) and transfusion of red blood cell ( p = 0.005) were independently associated with development of AKI after TBI. While hypertonic saline use was not associated with the development of AKI ( p = 0.067). The AUC of single cystatin C and predictive nomogram were 0.804 and 0.925, respectively. Conclusion Higher serum cystatin C is associated with development of AKI in TBI patients. Predictive nomogram incorporating cystatin C is beneficial for physicians to evaluate possibilities of AKI and consequently adjust treatment strategies to avoid occurrence of AKI.

show abstract

Incidence, Risk Factors, and Outcome of Acute Kidney Injury in Neurocritical Care

Cited by 30 publications

References 35 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

Acute kidney injury after prolonged neurosurgical operations

A nomogram based on serum cystatin C for predicting acute kidney injury in patients with traumatic brain injury

Contact Info

Product

Resources

About