Investigating an appropriate indicator of acute kidney injury for patient prognosis following lung transplantation.

IF 3 3区医学 Q1 UROLOGY & NEPHROLOGY

Renal Failure Pub Date : 2024-12-01 Epub Date: 2024-09-20 DOI:10.1080/0886022X.2024.2406403

Wenwen Du, Dan Zhang, Wenqian Chen, Wenhui Chen, Pengmei Li, Xiaoxing Wang

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引用次数: 0

Abstract

Objective: The purpose of this study was to investigate the correlation between different subtypes of acute kidney injury (AKI) and clinical outcomes following lung transplantation (LTx) and to identify a reliable indicator for predicting poor prognosis in the LTx population.

Methods: We retrospectively analyzed the clinical data of 279 LTx patients from August 2016 to March 2023. The AKI subtypes included AKI, persistent AKI on Day 7 (P7-AKI) and Day 14 (P14-AKI) after LTx, and AKI stages. The correlations of these factors with respiratory outcomes, mortality at 90 days, mortality at 1 year and data finalization were assessed, and the risk factors for the selected AKI subtypes were evaluated.

Results: AKI occurred in 215 patients (77.1%), with 129 (46.2%) experiencing P7-AKI and 95 (34.1%) experiencing P14-AKI. P7-AKI was associated with more respiratory and mortality outcomes than were AKI and AKI stages, and P7-AKI surpassed P14-AKI in terms of a shorter diagnostic time. After adjusting for age, sex, BMI, type of transplant, transplant diagnosis and comorbidities, P7-AKI independently correlated with increased mortality risk at 90 days [HR 12.312 (95% CI: 2.839-53.402)], 1 year [HR 3.847 (95% CI: 1.840-8.044)], and data finalization [HR 2.010 (95% CI: 1.331-3.033)]. Five variables were identified as independent predictors for P7-AKI, including preoperative body mass index, prothrombin activity, hemoglobin and serum creatinine, and intraoperative colloid administration.

Conclusion: P7-AKI has been identified as a reliable indicator for predicting adverse outcomes in LTx patients, which may assist healthcare professionals in identifying high-risk individuals.

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研究用于肺移植术后患者预后的急性肾损伤适当指标。

研究目的本研究旨在探讨不同亚型急性肾损伤（AKI）与肺移植（LTx）后临床结局之间的相关性，并找出预测LTx人群不良预后的可靠指标：我们回顾性分析了2016年8月至2023年3月期间279例LTx患者的临床数据。AKI亚型包括AKI、LTx后第7天（P7-AKI）和第14天（P14-AKI）的持续性AKI以及AKI分期。评估了这些因素与呼吸系统预后、90天死亡率、1年死亡率和最终数据的相关性，并对选定的AKI亚型的风险因素进行了评估：215名患者（77.1%）发生了AKI，其中129名患者（46.2%）发生了P7-AKI，95名患者（34.1%）发生了P14-AKI。与AKI和AKI分期相比，P7-AKI与更多的呼吸系统和死亡结果相关，P7-AKI在诊断时间上超过了P14-AKI。在对年龄、性别、体重指数、移植类型、移植诊断和合并症进行调整后，P7-AKI 与 90 天[HR 12.312 (95% CI: 2.839-53.402)]、1 年[HR 3.847 (95% CI: 1.840-8.044)]和数据最终确定[HR 2.010 (95% CI: 1.331-3.033)]的死亡风险增加独立相关。五个变量被确定为 P7-AKI 的独立预测因素，包括术前体重指数、凝血酶原活动度、血红蛋白和血清肌酐以及术中胶体管理：结论：P7-AKI已被确定为预测LTx患者不良预后的可靠指标，可帮助医护人员识别高危人群。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Renal Failure 医学-泌尿学与肾脏学

CiteScore

3.90

自引率

13.30%

发文量

374

审稿时长

1 months

期刊介绍： Renal Failure primarily concentrates on acute renal injury and its consequence, but also addresses advances in the fields of chronic renal failure, hypertension, and renal transplantation. Bringing together both clinical and experimental aspects of renal failure, this publication presents timely, practical information on pathology and pathophysiology of acute renal failure; nephrotoxicity of drugs and other substances; prevention, treatment, and therapy of renal failure; renal failure in association with transplantation, hypertension, and diabetes mellitus.