Predictive factors for severe long-term chronic kidney disease after acute kidney injury requiring renal replacement therapy in critically ill patients: an ancillary study of the ELVIS randomized controlled trial

被引:6
作者
Soum, Edouard [1 ]
Timsit, Jean-Francois [2 ,3 ]
Ruckly, Stephane [4 ]
Gruson, Didier [5 ]
Canet, Emmanuel [6 ]
Klouche, Kada [7 ]
Argaud, Laurent [8 ]
Garrouste-Orgeas, Maite [9 ]
Mariat, Christophe [10 ]
Vincent, Francois [11 ]
Cayot, Sophie [12 ]
Darmon, Michael [13 ]
Bohe, Julien [14 ]
Schwebel, Carole [2 ]
Bouadma, Lila [3 ]
Dupuis, Claire [1 ]
Souweine, Bertrand [1 ,15 ]
Lautrette, Alexandre [1 ,15 ]
机构
[1] Montpied Teaching Hosp, Med Intens Care Unit, Intens Care Med, 54 Rue Montalembert,BP69, F-63003 Clermont Ferrand 1, France
[2] Albert Michallon Teaching Hosp, Med Intens Care Unit, Grenoble, France
[3] Bichat Claude Bernard Teaching Hosp, Med Intens Care Unit, Paris, France
[4] ICURESEARCH, Paris, France
[5] Pellegrin Teaching Hosp, Med Intens Care Unit, Bordeaux, France
[6] St Louis Teaching Hosp, Med Intens Care Unit, Paris, France
[7] Lapeyronie Teaching Hosp, Med Intens Care Unit, Montpellier, France
[8] Edouard Herriot Teaching Hosp, Med Intens Care Unit, Lyon, France
[9] French British Hosp, Med Unit, Levallois Perret, France
[10] Nord, Teaching Hosp, Nephrol & Crit Care Unit, St Etienne, France
[11] Avicenne Teaching Hosp, Med Intens Care Unit, Paris, France
[12] Estaing Teaching Hosp, Dept Anaesthesiol & Crit Care Med, Clermont Ferrand, France
[13] Nord Teaching Hosp, Med Intens Care Unit, St Etienne, France
[14] Hosp Civils Lyon, Med Intens Care Unit, Groupement Hosp Sud, Lyon, France
[15] Univ Clermont Auvergne, CNRS, UMR 6023, LMGE Lab Microorganismes Genome & Environm, Clermont Ferrand, France
关键词
Renal replacement therapy; Acute kidney injury; Critically ill patient; ICU; Outcome; Chronic kidney disease; INTERMITTENT HEMODIALYSIS; RECOVERY; MODALITY; OUTCOMES; INITIATION; FAILURE; ADULTS; RISK; RRT;
D O I
10.1186/s13054-022-04233-4
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Background: Acute kidney injury (AKI) requiring renal replacement therapy (RRT) is a serious complication in the ICU that results in increased mortality and risk of chronic kidney disease (CKD). Some studies suggest RRT modality may have an impact on long-term renal recovery after AKI. However, other predictive factors of severe long-term CKD in ICU patients with AKI requiring RRT are unknown. Methods: We performed an ancillary study of the multicenter ELVIS trial in the population with AKI requiring RRT. Patients alive 3 months after RRT initiation were eligible. Serum creatinine levels available at 3, 6 and 12 months and 3 and 5 years were recorded. CKD stage was determined according to the glomerular filtration rate as estimated by the CKD-EPI formula. At each timepoint, two groups of patients were compared, a no/mild CKD group with normal or mildly to moderately decreased renal function (stages 1, 2 and 3 of the international classification) and a severe CKD group (stages 4 and 5). Our objective was to identify predictive factors of severe long-term CKD. Results: Of the 287 eligible patients, 183 had follow-up at 3 months, 136 (74.3%) from the no/mild CKD group and 47 (25.7%) from the severe CKD group, and 122 patients at 5 years comprising 96 (78.7%) from the no/mild CKD group and 26 (21.3%) from the severe CKD group. Multivariate analysis showed that a long RRT period was associated with severe CKD up to 12 months-(ORM12 = 1.03 95% CI [1.02-1.05] per day) and that a high SOFA score at the initiation of RRT was not associated with severe CKD up to 5 years-(ORM60 = 0.85 95% CI [0.77-0.93] per point). Conclusion: Severe long-term CKD was found in 21% of ICU survivors who underwent RRT for AKI. The duration of the RRT in AKI patients was identified as a new predictive factor for severe long-term CKD. This finding should be taken into consideration in future studies on the prognosis of ICU patients with AKI requiring RRT.
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页数:10
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共 31 条
[1]  
[Anonymous], 2013, Kidney Int Suppl, V3, P19, DOI DOI 10.1038/KISUP.2012.64
[2]   Timing of Initiation of Renal-Replacement Therapy in Acute Kidney Injury [J].
Bagshaw, Sean M. ;
Wald, Ron ;
Adhikari, Neill K. J. ;
Bellomo, Rinaldo ;
da Costa, Bruno R. ;
Dreyfuss, Didier ;
Gallagher, Martin P. ;
Gaudry, Stephane ;
Hoste, Eric A. ;
Lamontagne, Francois ;
Joannidis, Michael ;
Landoni, Giovanni ;
Liu, Kathleen D. ;
McAuley, Daniel F. ;
McGuinness, Shay P. ;
Neyra, Javier A. ;
Nichol, Alistair D. ;
Ostermann, Marlies ;
Palevsky, Paul M. ;
Pettila, Ville ;
Quenot, Jean-Pierre ;
Qiu, Haibo ;
Rochwerg, Bram ;
Schneider, Antoine G. ;
Smith, Orla M. ;
Thome, Fernando ;
Thorpe, Kevin E. ;
Vaara, Suvi ;
Weir, Matthew ;
Wang, Amanda Y. ;
Young, Paul ;
Zarbock, Alexander .
NEW ENGLAND JOURNAL OF MEDICINE, 2020, 383 (03) :240-251
[3]  
Barbar SD, 2018, NEW ENGL J MED, V379, P1431, DOI [10.1056/NEJMoa1803213, 10.1056/nejmoa1803213]
[4]   Chronic Kidney Disease Diagnosis and Management: A Review [J].
Chen, Teresa K. ;
Knicely, Daphne H. ;
Grams, Morgan E. .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2019, 322 (13) :1294-1304
[5]   Chronic kidney disease after acute kidney injury: a systematic review and meta-analysis [J].
Coca, Steven G. ;
Singanamala, Swathi ;
Parikh, Chirag R. .
KIDNEY INTERNATIONAL, 2012, 81 (05) :442-448
[6]   Mechanisms of maladaptive repair after AKI leading to accelerated kidney ageing and CKD [J].
Ferenbach, David A. ;
Bonventre, Joseph V. .
NATURE REVIEWS NEPHROLOGY, 2015, 11 (05) :264-276
[7]   Renal recovery after acute kidney injury [J].
Forni, L. G. ;
Darmon, M. ;
Ostermann, M. ;
Oudemans-van Straaten, H. M. ;
Pettilae, V. ;
Prowle, J. R. ;
Schetz, M. ;
Joannidis, M. .
INTENSIVE CARE MEDICINE, 2017, 43 (06) :855-866
[8]   Long-term consequences of acute kidney injury: a narrative review [J].
Gameiro, Joana ;
Marques, Filipe ;
Lopes, Jose Antonio .
CLINICAL KIDNEY JOURNAL, 2021, 14 (03) :789-804
[9]   Three-year risk of cardiovascular disease among intensive care patients with acute kidney injury: a population-based cohort study [J].
Gammelager, Henrik ;
Christiansen, Christian Fynbo ;
Johansen, Martin Berg ;
Tonnesen, Else ;
Jespersen, Bente ;
Sorensen, Henrik Toft .
CRITICAL CARE, 2014, 18 (05)
[10]   Five-year risk of end-stage renal disease among intensive care patients surviving dialysis-requiring acute kidney injury: a nationwide cohort study [J].
Gammelager, Henrik ;
Christiansen, Christian Fynbo ;
Johansen, Martin Berg ;
Tonnesen, Else ;
Jespersen, Bente ;
Sorensen, Henrik Toft .
CRITICAL CARE, 2013, 17 (04)